Effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury; a randomized double-blind placebo-controlled clinical trial.

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Farzanegan, Gholam Reza; Derakhshan, Nima; Khalili, Hosseinali; Ghaffarpasand, Fariborz; Paydar, Shahram

2017-10-01

The aim of the current study was to investigate the effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury (TBI). The study was conducted as a randomized clinical trial during a 16-month period from May 2015 and August 2016 in a level I trauma center in Shiraz, Southern Iran. We included 65 patients with moderate (GCS: 9-13) to severe (GCS: 5-8) TBI who had brain contusions of less than 30cc volume. We excluded those who required surgical intervention. Patients were randomly assigned to receive daily 20mg atorvastatin for 10days (n=21) or placebo in the same dosage (n=23). The brain contusion volumetry was performed on days 0, 3 and 7 utilizing spiral thin-cut brain CT-Scan (1-mm thickness). The outcome measured included modified Rankin scale (MRS), Glasgow Outcome Scale (GOS) and Disability rating Scale (DRS) which were all evaluated 3months post-injury. There was no significant difference between two study group regarding the baseline, 3rd day and 7th day of the contusion volume and the rate of contusion expansion. However, functional outcome scales of GOS, MRS and DRS at 3-months post-injury were significantly better in atorvastatin arm of the study compared to placebo (p values of 0.043, 0.039 and 0.030 respectively). Even though atorvastatin was not found to be more effective than placebo in reducing contusion expansion rate, it was associated with improved functional outcomes at 3-months following moderate to severe TBI. Copyright © 2017 Elsevier Ltd. All rights reserved.

Monitoring lung contusion in a porcine polytrauma model using EIT: an application study.

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Santos, Susana Aguiar; Wembers, Carlos Castelar; Horst, Klemens; Pfeifer, Roman; Simon, Tim-Philipp; Pape, Hans-Christoph; Hildebrand, Frank; Czaplik, Michael; Leonhardt, Steffen; Teichmann, Daniel

2017-07-26

Lung contusion is the most common lung injury following blunt chest trauma which, in turn, is associated with high mortality rates (Gavelli et al 2002 Eur. Radiol. 12 1273-94). Lung contusion is characterized by hemorrhage and edema with consecutively reduced compliance. Objective and Approach: In this study, unilateral lung contusion and other traumata were induced in 12 pigs by using a bolt gun machine. To investigate the pathophysiological consequences of lung contusion, information on clinical parameters was collected and monitored regularly while animals were additionally monitored with electrical impedance tomography (EIT) before trauma, and at 4, 24, 48 and 72 h after polytrauma. Statistical analyses showed significant differences between the measurement time points in terms of lung compliance ([Formula: see text]) and in global EIT parameters, such as absolute global impedance (aGlobImp) ([Formula: see text]), tidal impedance variation (TIV) ([Formula: see text]) and the center of ventilation (CoV) ([Formula: see text]). Additionally, distinct analyses for the left (non-injured) and right (injured) lung were also performed. In this context, during the progress of lung contusion, significant changes were found for the injured lung in TIV ([Formula: see text]), global inhomogeneity ([Formula: see text]), regional ventilation delay ([Formula: see text]), CoV ([Formula: see text]) and in regions of non-ventilation (rNoVent) ([Formula: see text]). Furthermore, TIV and rNoVent were capable to differentiate the injured and the contralateral healthy lung at 4 and 24 h after injury (TIV: [Formula: see text] and [Formula: see text]; rNoVent: [Formula: see text] and [Formula: see text]). TIV reached a sensitivity of 82% (specificity of 100%) at 4 h and sensitivity of 82% (specificity of 82%) at 24 h after injury, in detecting lung contusion specific consequences. The results indicate that EIT might be a valuable tool to detect and to monitor lung injuries

Role of spared pathways in locomotor recovery after body-weight-supported treadmill training in contused rats.

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Singh, Anita; Balasubramanian, Sriram; Murray, Marion; Lemay, Michel; Houle, John

2011-12-01

Body-weight-supported treadmill training (BWSTT)-related locomotor recovery has been shown in spinalized animals. Only a few animal studies have demonstrated locomotor recovery after BWSTT in an incomplete spinal cord injury (SCI) model, such as contusion injury. The contribution of spared descending pathways after BWSTT to behavioral recovery is unclear. Our goal was to evaluate locomotor recovery in contused rats after BWSTT, and to study the role of spared pathways in spinal plasticity after BWSTT. Forty-eight rats received a contusion, a transection, or a contusion followed at 9 weeks by a second transection injury. Half of the animals in the three injury groups were given BWSTT for up to 8 weeks. Kinematics and the Basso-Beattie-Bresnahan (BBB) test assessed behavioral improvements. Changes in Hoffmann-reflex (H-reflex) rate depression property, soleus muscle mass, and sprouting of primary afferent fibers were also evaluated. BWSTT-contused animals showed accelerated locomotor recovery, improved H-reflex properties, reduced muscle atrophy, and decreased sprouting of small caliber afferent fibers. BBB scores were not improved by BWSTT. Untrained contused rats that received a transection exhibited a decrease in kinematic parameters immediately after the transection; in contrast, trained contused rats did not show an immediate decrease in kinematic parameters after transection. This suggests that BWSTT with spared descending pathways leads to neuroplasticity at the lumbar spinal level that is capable of maintaining locomotor activity. Discontinuing training after the transection in the trained contused rats abolished the improved kinematics within 2 weeks and led to a reversal of the improved H-reflex response, increased muscle atrophy, and an increase in primary afferent fiber sprouting. Thus continued training may be required for maintenance of the recovery. Transected animals had no effect of BWSTT, indicating that in the absence of spared pathways this

Frontal Lobe Contusion in Mice Chronically Impairs Prefrontal-Dependent Behavior.

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Austin Chou

Full Text Available Traumatic brain injury (TBI is a major cause of chronic disability in the world. Moderate to severe TBI often results in damage to the frontal lobe region and leads to cognitive, emotional, and social behavioral sequelae that negatively affect quality of life. More specifically, TBI patients often develop persistent deficits in social behavior, anxiety, and executive functions such as attention, mental flexibility, and task switching. These deficits are intrinsically associated with prefrontal cortex (PFC functionality. Currently, there is a lack of analogous, behaviorally characterized TBI models for investigating frontal lobe injuries despite the prevalence of focal contusions to the frontal lobe in TBI patients. We used the controlled cortical impact (CCI model in mice to generate a frontal lobe contusion and studied behavioral changes associated with PFC function. We found that unilateral frontal lobe contusion in mice produced long-term impairments to social recognition and reversal learning while having only a minor effect on anxiety and completely sparing rule shifting and hippocampal-dependent behavior.

Motor cortex and spinal cord neuromodulation promote corticospinal tract axonal outgrowth and motor recovery after cervical contusion spinal cord injury.

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Zareen, N; Shinozaki, M; Ryan, D; Alexander, H; Amer, A; Truong, D Q; Khadka, N; Sarkar, A; Naeem, S; Bikson, M; Martin, J H

2017-11-01

Cervical injuries are the most common form of SCI. In this study, we used a neuromodulatory approach to promote skilled movement recovery and repair of the corticospinal tract (CST) after a moderately severe C4 midline contusion in adult rats. We used bilateral epidural intermittent theta burst (iTBS) electrical stimulation of motor cortex to promote CST axonal sprouting and cathodal trans-spinal direct current stimulation (tsDCS) to enhance spinal cord activation to motor cortex stimulation after injury. We used Finite Element Method (FEM) modeling to direct tsDCS to the cervical enlargement. Combined iTBS-tsDCS was delivered for 30min daily for 10days. We compared the effect of stimulation on performance in the horizontal ladder and the Irvine Beattie and Bresnahan forepaw manipulation tasks and CST axonal sprouting in injury-only and injury+stimulation animals. The contusion eliminated the dorsal CST in all animals. tsDCS significantly enhanced motor cortex evoked responses after C4 injury. Using this combined spinal-M1 neuromodulatory approach, we found significant recovery of skilled locomotion and forepaw manipulation skills compared with injury-only controls. The spared CST axons caudal to the lesion in both animal groups derived mostly from lateral CST axons that populated the contralateral intermediate zone. Stimulation enhanced injury-dependent CST axonal outgrowth below and above the level of the injury. This dual neuromodulatory approach produced partial recovery of skilled motor behaviors that normally require integration of posture, upper limb sensory information, and intent for performance. We propose that the motor systems use these new CST projections to control movements better after injury. Copyright © 2017 Elsevier Inc. All rights reserved.

Pathological changes in the white matter after spinal contusion injury in the rat.

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C Joakim Ek

Full Text Available It has been shown previously that after spinal cord injury, the loss of grey matter is relatively faster than loss of white matter suggesting interventions to save white matter tracts offer better therapeutic possibilities. Loss of white matter in and around the injury site is believed to be the main underlying cause for the subsequent loss of neurological functions. In this study we used a series of techniques, including estimations of the number of axons with pathology, immunohistochemistry and mapping of distribution of pathological axons, to better understand the temporal and spatial pathological events in white matter following contusion injury to the rat spinal cord. There was an initial rapid loss of axons with no detectable further loss beyond 1 week after injury. Immunoreactivity for CNPase indicated that changes to oligodendrocytes are rapid, extending to several millimetres away from injury site and preceding much of the axonal loss, giving early prediction of the final volume of white matter that survived. It seems that in juvenile rats the myelination of axons in white matter tracts continues for some time, which has an important bearing on interpretation of our, and previous, studies. The amount of myelin debris and axon pathology progressively decreased with time but could still be observed at 10 weeks after injury, especially at more distant rostral and caudal levels from the injury site. This study provides new methods to assess injuries to spinal cord and indicates that early interventions are needed for the successful sparing of white matter tracts following injury.

Effects of photobiomodulation therapy and topical non-steroidal anti-inflammatory drug on skeletal muscle injury induced by contusion in rats-part 1: morphological and functional aspects.

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Tomazoni, Shaiane Silva; Frigo, Lúcio; Dos Reis Ferreira, Tereza Cristina; Casalechi, Heliodora Leão; Teixeira, Simone; de Almeida, Patrícia; Muscara, Marcelo Nicolas; Marcos, Rodrigo Labat; Serra, Andrey Jorge; de Carvalho, Paulo de Tarso Camillo; Leal-Junior, Ernesto Cesar Pinto

2017-12-01

Musculoskeletal injuries are very frequent and are responsible for causing pain and impairment of muscle function, as well as significant functional limitations. In the acute phase, the most prescribed treatment is with non-steroidal anti-inflammatory drugs (NSAIDs), despite their questionable effectiveness. However, the use of photobiomodulation therapy (PBMT) in musculoskeletal disorders has been increasing in the last few years, and this therapy appears to be an interesting alternative to the traditional drugs. The objective of the present study was to evaluate and compare the effects of PBMT, with different application doses, and topical NSAIDs, under morphological and functional parameters, during an acute inflammatory process triggered by a controlled model of musculoskeletal injury induced via contusion in rats. Muscle injury was induced by means of a single trauma to the animals' anterior tibialis muscle. After 1 h, the rats were treated with PBMT (830 nm; continuous mode, with a power output of 100 mW; 3.57 W/cm 2 ; 1 J-35.7 J/cm 2 , 3 J-107.1 J/cm 2 , and 9 J-321.4 J/cm 2 ; 10, 30, and 90 s) or diclofenac sodium for topical use (1 g). Morphological analysis (histology) and functional analysis (muscle work) were performed, 6, 12, and 24 h after induction of the injury. PBMT, with all doses tested, improved morphological changes caused by trauma; however, the 9 J (321.4 J/cm 2 ) dose was the most effective in organizing muscle fibers and cell nuclei. On the other hand, the use of diclofenac sodium produced only a slight improvement in morphological changes. Moreover, we observed a statistically significant increase of muscle work in the PBMT 3 J (107.1 J/cm 2 ) group in relation to the injury group and the diclofenac group (p topical use as a means to improve morphological and functional alterations due to muscle injury from contusion.

Daily propranolol prevents prolonged mobilization of hematopoietic progenitor cells in a rat model of lung contusion, hemorrhagic shock, and chronic stress.

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Bible, Letitia E; Pasupuleti, Latha V; Gore, Amy V; Sifri, Ziad C; Kannan, Kolenkode B; Mohr, Alicia M

2015-09-01

Propranolol has been shown previously to decrease the mobilization of hematopoietic progenitor cells (HPCs) after acute injury in rodent models; however, this acute injury model does not reflect the prolonged period of critical illness after severe trauma. Using our novel lung contusion/hemorrhagic shock/chronic restraint stress model, we hypothesize that daily administration of propranolol will decrease prolonged mobilization of HPCs without worsening lung healing. Male Sprague-Dawley rats underwent 6 days of restraint stress after undergoing lung contusion or lung contusion/hemorrhagic shock. Restraint stress consisted of a daily 2-hour period of restraint interrupted every 30 minutes by alarms and repositioning. Each day after the period of restraint stress, the rats received intraperitoneal propranolol (10 mg/kg). On day 7, peripheral blood was analyzed for granulocyte-colony stimulating factor (G-CSF) and stromal cell-derived factor 1 via enzyme-linked immunosorbent assay and for mobilization of HPCs using c-kit and CD71 flow cytometry. The lungs were examined histologically to grade injury. Seven days after lung contusion and lung contusion/hemorrhagic shock, the addition of chronic restraint stress significantly increased the mobilization of HPC, which was associated with persistently increased levels of G-CSF and increased lung injury scores. The addition of propranolol to lung contusion/chronic restraint stress and lung contusion/hemorrhagic shock/chronic restraint stress models greatly decreased HPC mobilization and restored G-CSF levels to that of naïve animals without worsening lung injury scores. The daily administration of propranolol after both lung contusion and lung contusion/hemorrhagic shock subjected to chronic restraint stress decreased the prolonged mobilization of HPC from the bone marrow and decreased plasma G-CSF levels. Despite the decrease in mobilization of HPC, lung healing did not worsen. Alleviating chronic stress with propranolol

Electroporation-mediated in vivo gene delivery of the Na+/K+-ATPase pump reduced lung injury in a mouse model of lung contusion.

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Machado-Aranda, David A; Suresh, M V; Yu, Bi; Raghavendran, Krishnan

2012-01-01

Lung contusion (LC) is an independent risk factor for acute respiratory distress syndrome. The final common pathway in ARDS involves accumulation of fluid in the alveoli. In this study, we demonstrate the application of a potential gene therapy approach by delivering the Na+/K+-ATPase pump subunits in a murine model of LC. We hypothesized that restoring the activity of the pump will result in removal of excess alveolar fluid and additionally reduce inflammation. Under anesthesia, C57/BL6 mice were struck along the right posterior axillary line 1 cm above the costal margin with a cortical contusion impactor. Immediately afterward, 100 μg of plasmid DNA coding for the α,β of the Na+/K+-ATPase pump were instilled into the lungs (LC-electroporation-pump group). Contusion only (LC-only) and a sham saline instillation group after contusion were used as controls (LC-electroporation-sham). By using a BTX 830 electroporator, eight electrical pulses of 200 V/cm field strength were applied transthoracically. Mice were killed at 24 hours, 48 hours, and 72 hours after delivery. Bronchial alveolar lavage was recollected to measure albumin and cytokines by enzyme-linked immunosorbent assay. Pulmonary compliance was measured, and lungs were subject to histopathologic analysis. After the electroporation and delivery of genes coding for the α,β subunits of the Na+/K+-ATPase pump, there was a significant mitigation of acute lung injury as evidenced by reduction in bronchial alveolar lavage levels of albumin, improved pressure volume curves, and reduced inflammation seen on histology. Electroporation-mediated gene transfer of the subunits of the Na+/K+-ATPase pump enhanced recovery from acute inflammatory lung injury after LC.

X-ray picture of lung contusion in penetrating chest wounds

International Nuclear Information System (INIS)

Ishchenko, B.I.; Bisenkov, L.N.; Bol'shakov, G.A.

1983-01-01

From the view-point of an x-ray appearance gUnshot lUng in uries are characterized by nonhomogeneous darkening of an oblong or spheroidal shape which is more intense in the center with unclear contours UsUally sited in the peripheral zones of the lung. Sometimes a cavity of 4-5 cm in diame-- ter is determined in the zone of contUsion. In half of the patients contusion injuries of the lungs were combined with hemopneumothorax. With respect to differential diagnosis it is necessary to distinguish lung contusions from atelectasis, pneumonia and abscesses. Importance shoUld be attached to the peculiarities of a skialogical picture, the time of development and the time course of changes in the lungs, the nature and degree of clinical minifestations

Feasibility of Diffusion Tensor Imaging for Assessing Functional Recovery in Rats with Olfactory Ensheathing Cell Transplantation After Contusive Spinal Cord Injury (SCI).

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Gu, Mengchao; Gao, Zhengchao; Li, Xiaohui; Zhao, Feng; Guo, Lei; Liu, Jiantao; He, Xijing

2017-06-17

BACKGROUND Olfactory ensheathing cell transplantation is a promising treatment for spinal cord injury. Diffusion tensor imaging has been applied to assess various kinds of spinal cord injury. However, it has rarely been used to evaluate the beneficial effects of olfactory ensheathing cell transplantation. This study aimed to explore the feasibility of diffusion tensor imaging in the evaluation of functional recovery in rats with olfactory ensheathing cell transplantation after contusive spinal cord injury. MATERIAL AND METHODS Immunofluorescence staining was performed to determine the purity of olfactory ensheathing cells. Rats received cell transplantation at week 1 after injury. Basso, Beattie, and Bresnahan score was used to assess the functional recovery. Magnetic resonance imaging was applied weekly, including diffusion tensor imaging. Diffusion tensor tractography was reconstructed to visualize the repair process. RESULTS The results showed that olfactory ensheathing cell transplantation increased the functional and histological recovery and restrained the secondary injury process after the initial spinal cord injury. The fractional anisotropy values in rats with cell transplantation were significantly higher than those in the control group, while the apparent diffusion coefficient values were significantly lower. Basso, Beattie, and Bresnahan score was positively and linearly correlated with fractional anisotropy value, and it was negatively and linearly correlated with apparent diffusion coefficient value. CONCLUSIONS These findings suggest that diffusion tensor imaging parameters are sensitive biomarker indices for olfactory ensheathing cell transplantation interventions, and diffusion tensor imaging scan can reflect the functional recovery promoted by the olfactory ensheathing cell transplantation after contusive spinal cord injury.

Intravenous Infusion of Magnesium Chloride Improves Epicenter Blood Flow during the Acute Stage of Contusive Spinal Cord Injury in Rats

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Muradov, Johongir M.

2013-01-01

Abstract Vasospasm, hemorrhage, and loss of microvessels at the site of contusive or compressive spinal cord injury lead to infarction and initiate secondary degeneration. Here, we used intravenous injection of endothelial-binding lectin followed by histology to show that the number of perfused microvessels at the injury site is decreased by 80–90% as early as 20 min following a moderate T9 contusion in adult female rats. Hemorrhage within the spinal cord also was maximal at 20 min, consistent with its vasoconstrictive actions in the central nervous system (CNS). Microvascular blood flow recovered to up to 50% of normal volume in the injury penumbra by 6 h, but not at the epicenter. A comparison with an endothelial cell marker suggested that many microvessels fail to be reperfused up to 48 h post-injury. The ischemia was probably caused by vasospasm of vessels penetrating the parenchyma, because repeated Doppler measurements over the spinal cord showed a doubling of total blood flow over the first 12 h. Moreover, intravenous infusion of magnesium chloride, used clinically to treat CNS vasospasm, greatly improved the number of perfused microvessels at 24 and 48 h. The magnesium treatment seemed safe as it did not increase hemorrhage, despite the improved parenchymal blood flow. However, the treatment did not reduce acute microvessel, motor neuron or oligodendrocyte loss, and when infused for 7 days did not affect functional recovery or spared epicenter white matter over a 4 week period. These data suggest that microvascular blood flow can be restored with a clinically relevant treatment following spinal cord injury. PMID:23302047

Ascending central canal dilation and progressive ependymal disruption in a contusion model of rodent chronic spinal cord injury

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Keirstead Hans S

2007-09-01

Full Text Available Abstract Background Chronic spinal cord injury (SCI can lead to an insidious decline in motor and sensory function in individuals even years after the initial injury and is accompanied by a slow and progressive cytoarchitectural destruction. At present, no pathological mechanisms satisfactorily explain the ongoing degeneration. Methods Adult female Sprague-Dawley rats were anesthetized laminectomized at T10 and received spinal cord contusion injuries with a force of 250 kilodynes using an Infinite Horizon Impactor. Animals were randomly distributed into 5 groups and killed 1 (n = 4, 28 (n = 4, 120 (n = 4, 450 (n = 5, or 540 (n = 5 days after injury. Morphometric and immunohistochemical studies were then performed on 1 mm block sections, 6 mm cranial and 6 mm caudal to the lesion epicenter. The SPSS 11.5 t test was used to determine differences between quantitative measures. Results Here, we document the first report of an ascending central canal dilation and progressive ependymal disruption cranial to the epicenter of injury in a contusion model of chronic SCI, which was characterized by extensive dural fibrosis and intraparenchymal cystic cavitation. Expansion of the central canal lumen beyond a critical diameter corresponded with ependymal cell ciliary loss, an empirically predictable thinning of the ependymal region, and a decrease in cell proliferation in the ependymal region. Large, aneurysmal dilations of the central canal were accompanied by disruptions in the ependymal layer, periependymal edema and gliosis, and destruction of the adjacent neuropil. Conclusion Cells of the ependymal region play an important role in CSF homeostasis, cellular signaling and wound repair in the spinal cord. The possible effects of this ascending pathology on ependymal function are discussed. Our studies suggest central canal dilation and ependymal region disruption as steps in the pathogenesis of chronic SCI, identify central canal dilation as a marker of

Effects of photobiomodulation therapy and topical non-steroidal anti-inflammatory drug on skeletal muscle injury induced by contusion in rats-part 2: biochemical aspects.

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Tomazoni, Shaiane Silva; Frigo, Lúcio; Dos Reis Ferreira, Tereza Cristina; Casalechi, Heliodora Leão; Teixeira, Simone; de Almeida, Patrícia; Muscara, Marcelo Nicolas; Marcos, Rodrigo Labat; Serra, Andrey Jorge; de Carvalho, Paulo de Tarso Camillo; Leal-Junior, Ernesto Cesar Pinto

2017-11-01

Muscle injuries trigger an inflammatory process, releasing important biochemical markers for tissue regeneration. The use of non-steroidal anti-inflammatory drugs (NSAIDs) is the treatment of choice to promote pain relief due to muscle injury. NSAIDs exhibit several adverse effects and their efficacy is questionable. Photobiomodulation therapy (PBMT) has been demonstrated to effectively modulate inflammation induced from musculoskeletal disorders and may be used as an alternative to NSAIDs. Here, we assessed and compared the effects of different doses of PBMT and topical NSAIDs on biochemical parameters during an acute inflammatory process triggered by a controlled model of contusion-induced musculoskeletal injury in rats. Muscle injury was induced by trauma to the anterior tibial muscle of rats. After 1 h, rats were treated with PBMT (830 nm, continuous mode, 100 mW of power, 35.71 W/cm 2 ; 1, 3, and 9 J; 10, 30, and 90 s) or diclofenac sodium (1 g). Our results demonstrated that PBMT, 1 J (35.7 J/cm 2 ), 3 J (107.1 J/cm 2 ), and 9 J (321.4 J/cm 2 ) reduced the expression of tumor necrosis factor alpha (TNF-α) and cyclooxygenase-2 (COX-2) genes at all assessed times as compared to the injury and diclofenac groups (p levels of COX-2 only in relation to the injury group (p levels of cytokines TNF-α, interleukin (IL)-1β, and IL-6 at all assessed times as compared to the injury and diclofenac groups (p topical NSAIDs in the modulation of the inflammatory process caused by muscle contusion injuries.

Desferrioxamine Reduces Oxidative Stress in the Lung Contusion

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Umit Nusret Basaran

2013-01-01

Full Text Available Our hypothesis in this study is that desferrioxamine (DFX has therapeutic effects on experimental lung contusions in rats. The rats were divided into four groups (n=8: control, control+DFX, contusion, and contusion+DFX. In the control+DFX and contusion+DFX groups, 100 mg/kg DFX was given intraperitoneally once a day just after the contusion and the day after the contusion. Contusions led to a meaningful rise in the malondialdehyde (MDA level in lung tissue. MDA levels in the contusion+DFX group experienced a significant decline. Glutathione levels were significantly lower in the contusion group than in the control group and significantly higher in the contusion+DFX group. Glutathione peroxidase (GPx and superoxide dismutase (SOD levels in the contusion group were significantly lower than those in the control group. In the contusion+DFX group, SOD and GPx levels were significantly higher than those in the contusion group. In light microscopic evaluation, the contusion and contusion+DFX groups showed edema, hemorrhage, alveolar destruction, and leukocyte infiltration. However, histological scoring of the contusion+DFX group was significantly more positive than that of the contusion group. The iNOS staining in the contusion group was significantly more intensive than that in all other groups. DFX reduced iNOS staining significantly in comparison to the contusion group. This study showed that DFX reduced oxidative stress in lung contusions in rats and histopathologically ensured the recovery of the lung tissue.

Hemodynamic Instability after Low-Energy Thigh Contusion Caused by Injury to the Femoral Artery: A Case Report and Literature Review

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Juan Miguel Rodríguez-Roiz

2016-01-01

Full Text Available Acute vascular injuries have been described in relation to high-energy trauma accidents or in patients undergoing surgery in the femoral area. We describe a healthy patient who sustained a direct, low-energy contusion in the thigh and presented haemodynamic instability. Arteriography was used to locate the point of bleeding, and embolisation and vessel occlusion were carried out to stop the haemorrhage. The genetic study identified the COL3A1 gene mutation; accordingly, the patient was diagnosed with the Ehlers-Danlos syndrome type IV (vascular type.

Efficacy and tolerability of a new ibuprofen 200mg plaster in patients with acute sports-related traumatic blunt soft tissue injury/contusion.

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Predel, Hans-Georg; Giannetti, Bruno; Connolly, Mark P; Lewis, Fraser; Bhatt, Aomesh

2018-01-01

Ibuprofen is used for the treatment of non-serious pain. This study assessed the efficacy and safety of a new ibuprofen plaster for the treatment of pain associated with acute sports impact injuries/contusions. In this randomised, double-blind, multi-centre, placebo controlled, parallel group study, adults (n = 130; 18-58 years of age) diagnosed with acute sports-related blunt soft tissue injury/contusion were randomized to receive either ibuprofen 200 mg plaster or placebo plaster. Plasters were administered once daily for five consecutive days. The primary assessment was area under the visual analogue scale (VAS) of pain on movement (POM) over 0 to three days (VAS AUC 0-3d ). Other endpoints included algometry AUC from 0 to three days (AUC 0-3d ) and 0 to five days (AUC 0-5d ), to evaluate improvement of sensitivity at the injured site, and patient and investigator global assessment of efficacy. Safety was monitored throughout the study. The ibuprofen plaster resulted in superior reduction in AUC 0-3d compared with placebo; the Least Squares (LS) mean difference was 662.82 mm*h in favour of the ibuprofen 200mg plaster (P = 0.0011). The greater improvement in VAS AUC of POM was also observed after 12 h, 24 h, and five days of therapy. Tenderness also significantly improved with the ibuprofen plaster compared with placebo; LS mean difference in algometry/tenderness AUC 0-3d was 1.87 N/cm 2 *d and AUC 0-5d was 1.87 N/cm 2 *d (P values ≤0.0004). At all study timepoints, a greater percentage of patients and investigators rated the effectiveness of the ibuprofen 200 mg plaster as good/excellent than the placebo plaster. Treatment-emergent adverse events for the ibuprofen plaster were few (≤1.5%) and were mild in severity. The results of this study indicate 200 mg plaster is effective and safe for the treatment of pain due to acute sports-related traumatic blunt soft tissue injury/contusion in adults.

Bone marrow stromal cells elicit tissue sparing after acute but not delayed transplantation into the contused adult rat thoracic spinal cord.

NARCIS (Netherlands)

Tewarie, R.D.; Hurtado, A.; Ritfeld, G.J.; Rahiem, S.T.; Wendell, D.F.; Barroso, M.M.; Grotenhuis, J.A.; Oudega, M.

2009-01-01

Bone marrow stromal cells (BMSC) transplanted into the contused spinal cord may support repair by improving tissue sparing. We injected allogeneic BMSC into the moderately contused adult rat thoracic spinal cord at 15 min (acute) and at 3, 7, and 21 days (delayed) post-injury and quantified tissue

1H-MR spectroscopy of dog's brain contusion and laceration

International Nuclear Information System (INIS)

Wang Xuejian; Yu Hui; Shen Guiquan; Wei Yuqing; Li Dongfang; Shi Qianhua; Xiang Zhihua; Zhang Tijiang

2006-01-01

Objective: To investigate proton magnetic resonance spectroscopy ( 1 H-MRS) findings and value on dog's brain contusion and laceration. Methods: Models of focal brain contusion and laceration in 10 dogs were established through hitting on the right frontal-parietal lobe with a freely drop of 200g weight at 1.3 m height. Serial examinations (1 h, 24 h, 72 h, 5 day, 8 day and 14 day after trauma) were performed with conventional MRI and 1 H-MRS. NAA/Cr, Cho/Cr and NAA/Cho rates were analyzed with GE system 1.5 T scanner and relative software. After examination, all dogs were executed to death. Pathological study was performed at local brain contusion. Results: 1 h and 24 h-post trauma, NAA/Cr, Cho/Cr, NAA/Cho were significantly reduced (NAA/Cr 0.843±0.214, 0.862±0.204, contralateral ones 1.069±0.284, 1.048±0.232, t=-7.227, -6.718, Cho/Cr 1.181±0.224, 1.243±0.134, contralateral 1.415±0.305, 1.455±0.159, t=-4.332, -4.489, NAA/Cho 0.701±0.147, 0.536±0.136, contralateral 0.832±0.245, 0.613±0.165, t=-2.652, -2.665. P 0.05), Cho/Cr was significantly increased (1.457±0.168, 1.572±0.374, contralateral 1.334±0.174, 1.366±0.352, t=7.312, 3.201. P<0.05). Inflammatory and glial hyperplasia was more significant, granuloma were seen. Lipid and Lac peak were not seen at all stages. Conclusion: MRS could be a methods to monitor neuron injury and repair, and dynamically to detect the metabolic changes of brain contusion and laceration, reflecting injury severity and provide theory data for early treatment and predicting long-term outcome after trauma. (authors)

Studies of Mechanisms of Pharmacological Enhancement of Functional Recovery After Cortical Contusion

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1993-01-29

ablation, as described in detail elsewhere (4,8,9). In other projects, SMCx injury was induced via contusion of the cortex through a craniotomy site...in vivo microdialysis study in the awake rat. J. Neurochem. 76. Steindler D.A. (1981) Locus coeruleus neurons have axons that branch to the forebrain...microdialysis study in the awake rat. J. Neurochem. Weisend, M.P. and Feeney, D.M. (Submitted) Brain temperature before and after traumatic brain injury is

Crocin improved locomotor function and mechanical behavior in the rat model of contused spinal cord injury through decreasing calcitonin gene related peptide (CGRP).

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Karami, Masoume; Bathaie, S Zahra; Tiraihi, Taqi; Habibi-Rezaei, Mehran; Arabkheradmand, Jalil; Faghihzadeh, Soghrat

2013-12-15

Various approaches have been offered to alleviate chronic pain resulting from spinal cord injuries (SCIs). Application of herbs and natural products, with potentially lower adverse effects, to cure diseases has been recommended in both traditional and modern medicines. Here, the effect of crocin on chronic pain induced by spinal cord contusion was investigated in an animal model. Female Wistar rats were randomly divided into five groups (5 rats in each); three groups were contused at the L1 level. One group was treated with crocin (150mg/kg) two weeks after spinal cord injury; the second group, control, was treated with vehicle only; and the third group was treated with ketoprofen. Two normal groups were also considered with or without crocin treatment. The mechanical behavioral test, the locomotor recovery test and the thermal behavioral test were applied weekly to evaluate the injury and recovery of rats. Significant improvements (plocomotor recovery tests were seen in the rats treated with crocin. Thermal behavioral test did not show any significant changes due to crocin treatment. Plasma concentration of calcitonin-gene related peptide (CGRP) changed from 780.2±2.3 to 1140.3±4.5pg/ml due to SCI and reached 789.1±2.7pg/ml after crocin treatment. These changes were significant at the level of p<0.05. The present study shows the beneficial effects of crocin treatment on chronic pain induced by SCI, through decreasing CGRP as an important mediator of inflammation and pain. Copyright © 2013 Elsevier GmbH. All rights reserved.

Phase analysis of gated blood pool scintigraphy in traumatic myocardial contusion

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Nishimaki, Hiroshi; Kobayashi, Akiyoshi

1994-01-01

It is not easy to make a diagnosis of myocardial contusion following blunt chest trauma, because most patients have many other concurrent injuries with diverse symptoms. The usefulness of phase analysis of gated blood pool scintigraphy (GBPS) for myocardial contusion following blunt chest trauma was evaluated. Thirty-eight patients who had been strongly suspected of having myocardial contusion from clinical symptoms and electrocardiograms underwent phase analysis of GBPS. The results of phase analysis were compared with those of two-dimensional echocardiography (2-D Echo) and CPK-MB fraction measurement in all patients, with those of 201 TlCl myocardial scintigraphy in 35 patients and with those of 99m Tc-pyrophosphate scintigraphy in 10 patients. In 29 patients (76.3%), the results of phase analysis matched those of 2-D Echo. Two patients (5.3%) who were judged as positive by 2-D Echo and as negative by phase analysis had only rupture of the chordae. Only one of two other patients who were judged as negative by 2-D Echo and as positive by phase analysis was judged as positive by 201 TlCl myocardial scintigraphy. The results of both 2-D Echo and phase analysis were not well correlated with those of CPK-MB fraction measurement and 99m Tc pyrophosphate scintigraphy. It is concluded that phase analysis of GBPS, as well as 2-D Echo, is useful for diagnosing myocardial contusion, and that phase analysis is most useful for diagnosing myocardial contusion in patients who cannot be examined by 2-D Echo because of the presence of pneumothorax and/or subcutaneous emphysema in the anterior chest wall. (author)

Phase analysis of gated blood pool scintigraphy in traumatic myocardial contusion

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Nishimaki, Hiroshi; Kobayashi, Akiyoshi (Kitasato Univ., Sagamihara, Kanagawa (Japan). School of Medicine)

1994-01-01

It is not easy to make a diagnosis of myocardial contusion following blunt chest trauma, because most patients have many other concurrent injuries with diverse symptoms. The usefulness of phase analysis of gated blood pool scintigraphy (GBPS) for myocardial contusion following blunt chest trauma was evaluated. Thirty-eight patients who had been strongly suspected of having myocardial contusion from clinical symptoms and electrocardiograms underwent phase analysis of GBPS. The results of phase analysis were compared with those of two-dimensional echocardiography (2-D Echo) and CPK-MB fraction measurement in all patients, with those of [sup 201]TlCl myocardial scintigraphy in 35 patients and with those of [sup 99m]Tc-pyrophosphate scintigraphy in 10 patients. In 29 patients (76.3%), the results of phase analysis matched those of 2-D Echo. Two patients (5.3%) who were judged as positive by 2-D Echo and as negative by phase analysis had only rupture of the chordae. Only one of two other patients who were judged as negative by 2-D Echo and as positive by phase analysis was judged as positive by [sup 201]TlCl myocardial scintigraphy. The results of both 2-D Echo and phase analysis were not well correlated with those of CPK-MB fraction measurement and [sup 99m]Tc pyrophosphate scintigraphy. It is concluded that phase analysis of GBPS, as well as 2-D Echo, is useful for diagnosing myocardial contusion, and that phase analysis is most useful for diagnosing myocardial contusion in patients who cannot be examined by 2-D Echo because of the presence of pneumothorax and/or subcutaneous emphysema in the anterior chest wall. (author).

Spinal electro-magnetic stimulation combined with transgene delivery of neurotrophin NT-3 and exercise: novel combination therapy for spinal contusion injury.

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Petrosyan, Hayk A; Alessi, Valentina; Hunanyan, Arsen S; Sisto, Sue A; Arvanian, Victor L

2015-11-01

Our recent terminal experiments revealed that administration of a single train of repetitive spinal electromagnetic stimulation (sEMS; 35 min) enhanced synaptic plasticity in spinal circuitry following lateral hemisection spinal cord injury. In the current study, we have examined effects of repetitive sEMS applied as a single train and chronically (5 wk, every other day) following thoracic T10 contusion. Chronic studies involved examination of systematic sEMS administration alone and combined with exercise training and transgene delivery of neurotrophin [adeno-associated virus 10-neurotrophin 3 (AAV10-NT3)]. Electrophysiological intracellular/extracellular recordings, immunohistochemistry, behavioral testing, and anatomical tracing were performed to assess effects of treatments. We found that administration of a single sEMS train induced transient facilitation of transmission through preserved lateral white matter to motoneurons and hindlimb muscles in chronically contused rats with effects lasting for at least 2 h. These physiological changes associated with increased immunoreactivity of GluR1 and GluR2/3 glutamate receptors in lumbar neurons. Systematic administration of sEMS alone for 5 wk, however, was unable to induce cumulative improvements of transmission in spinomuscular circuitry or improve impaired motor function following thoracic contusion. Encouragingly, chronic administration of sEMS, followed by exercise training (running in an exercise ball and swimming), induced the following: 1) sustained strengthening of transmission to lumbar motoneurons and hindlimb muscles, 2) better retrograde transport of anatomical tracer, and 3) improved locomotor function. Greatest improvements were seen in the group that received exercise combined with sEMS and AAV-NT3.

Degeneration of Phrenic Motor Neurons Induces Long-Term Diaphragm Deficits following Mid-Cervical Spinal Contusion in Mice

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Nicaise, Charles; Putatunda, Rajarshi; Hala, Tamara J.; Regan, Kathleen A.; Frank, David M.; Brion, Jean-Pierre; Leroy, Karelle; Pochet, Roland; Wright, Megan C.

2012-01-01

Abstract A primary cause of morbidity and mortality following cervical spinal cord injury (SCI) is respiratory compromise, regardless of the level of trauma. In particular, SCI at mid-cervical regions targets degeneration of both descending bulbospinal respiratory axons and cell bodies of phrenic motor neurons, resulting in deficits in the function of the diaphragm, the primary muscle of inspiration. Contusion-type trauma to the cervical spinal cord is one of the most common forms of human SCI; however, few studies have evaluated mid-cervical contusion in animal models or characterized consequent histopathological and functional effects of degeneration of phrenic motor neuron–diaphragm circuitry. We have generated a mouse model of cervical contusion SCI that unilaterally targets both C4 and C5 levels, the location of the phrenic motor neuron pool, and have examined histological and functional outcomes for up to 6 weeks post-injury. We report that phrenic motor neuron loss in cervical spinal cord, phrenic nerve axonal degeneration, and denervation at diaphragm neuromuscular junctions (NMJ) resulted in compromised ipsilateral diaphragm function, as demonstrated by persistent reduction in diaphragm compound muscle action potential amplitudes following phrenic nerve stimulation and abnormalities in spontaneous diaphragm electromyography (EMG) recordings. This injury paradigm is reproducible, does not require ventilatory assistance, and provides proof-of-principle that generation of unilateral cervical contusion is a feasible strategy for modeling diaphragmatic/respiratory deficits in mice. This study and its accompanying analyses pave the way for using transgenic mouse technology to explore the function of specific genes in the pathophysiology of phrenic motor neuron degeneration and respiratory dysfunction following cervical SCI. PMID:23176637

Bipedal locomotion of bonnet macaques after spinal cord injury.

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Babu, Rangasamy Suresh; Anand, P; Jeraud, Mathew; Periasamy, P; Namasivayam, A

2007-10-01

Experimental studies concerning the analysis of locomotor behavior in spinal cord injury research are widely performed in rodent models. The purpose of this study was to quantitatively evaluate the degree of functional recovery in reflex components and bipedal locomotor behavior of bonnet macaques (Macaca radiata) after spinal contusive injury. Six monkeys were tested for various reflex components (grasping, righting, hopping, extension withdrawal) and were trained preoperatively to walk in bipedal fashion on the simple and complex locomotor runways (narrow beam, grid, inclined plane, treadmill) of this investigation. The overall performance of the animals'motor behavior and the functional status of limb movements during bipedal locomotion were graded by the Combined Behavioral Score (CBS) system. Using the simple Allen weight-drop technique, a contusive injury was produced by dropping a 13-g weight from a height of 30 cm to the exposed spinal cord at the T12-L1 vertebral level of the trained monkeys. All the monkeys showed significant impairments in every reflex activity and in walking behavior during the early part of the postoperative period. In subsequent periods, the animals displayed mild alterations in certain reflex responses, such as grasping, extension withdrawal, and placing reflexes, which persisted through a 1-year follow-up. The contused animals traversed locomotor runways--narrow beam, incline plane, and grid runways--with more steps and few errors, as evaluated with the CBS system. Eventually, the behavioral performance of all spinal-contused monkeys recovered to near-preoperative level by the fifth postoperative month. The findings of this study reveal the recovery time course of various reflex components and bipedal locomotor behavior of spinal-contused macaques on runways for a postoperative period of up to 1 year. Our spinal cord research in primates is advantageous in understanding the characteristics of hind limb functions only, which possibly

Thoracic rat spinal cord contusion injury induces remote spinal gliogenesis but not neurogenesis or gliogenesis in the brain.

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Steffen Franz

Full Text Available After spinal cord injury, transected axons fail to regenerate, yet significant, spontaneous functional improvement can be observed over time. Distinct central nervous system regions retain the capacity to generate new neurons and glia from an endogenous pool of progenitor cells and to compensate neural cell loss following certain lesions. The aim of the present study was to investigate whether endogenous cell replacement (neurogenesis or gliogenesis in the brain (subventricular zone, SVZ; corpus callosum, CC; hippocampus, HC; and motor cortex, MC or cervical spinal cord might represent a structural correlate for spontaneous locomotor recovery after a thoracic spinal cord injury. Adult Fischer 344 rats received severe contusion injuries (200 kDyn of the mid-thoracic spinal cord using an Infinite Horizon Impactor. Uninjured rats served as controls. From 4 to 14 days post-injury, both groups received injections of bromodeoxyuridine (BrdU to label dividing cells. Over the course of six weeks post-injury, spontaneous recovery of locomotor function occurred. Survival of newly generated cells was unaltered in the SVZ, HC, CC, and the MC. Neurogenesis, as determined by identification and quantification of doublecortin immunoreactive neuroblasts or BrdU/neuronal nuclear antigen double positive newly generated neurons, was not present in non-neurogenic regions (MC, CC, and cervical spinal cord and unaltered in neurogenic regions (dentate gyrus and SVZ of the brain. The lack of neuronal replacement in the brain and spinal cord after spinal cord injury precludes any relevance for spontaneous recovery of locomotor function. Gliogenesis was increased in the cervical spinal cord remote from the injury site, however, is unlikely to contribute to functional improvement.

Persistent polyuria in a rat spinal contusion model.

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Ward, Patricia J; Hubscher, Charles H

2012-10-10

Polyuria contributes to bladder overdistention, which confounds both lower and upper urinary tract management in individuals having a spinal cord injury (SCI). Bladder overdistention post-SCI is one of the most common triggers for autonomic dysreflexia, a potentially life-threatening condition. Post-SCI polyuria is thought to result from loss of vascular tone in the lower extremities, leading to edema and subsequent excess fluid, resulting in polyuria. Mild SCIs that have near complete recovery would therefore be expected to have little to no polyuria, while severe injuries resulting in flaccid limbs and lower extremity edema would be expected to exhibit severe polyuria. Since interventions that may decrease lower extremity edema are recommended to lessen the severity of polyuria, step training (which promotes vascular circulation) was evaluated as a therapy to reduce post-SCI polyuria. In the present study, polyuria was evaluated in mild, moderate, and severe contusive SCI in adult male rats. The animals were housed in metabolic cages for 24-hour periods pre- and post-SCI (to 6 weeks). Urine, feces, food, water, and body weights were collected. Other assessments included residual expressed urine volumes, locomotor scoring, in-cage activity, and lesion histology. SCI produced an immediate increase in 24-hour urine collection, as early as 3 days post-SCI. Approximately 2.6-fold increases in urine collection occurred from weeks 1-6 post-SCI for all injury severities. Even with substantial gains in locomotor and bladder function following a mild SCI, polyuria remained severe. Step training (30 min/day, 6 days/week) did not alleviate polyuria in the moderate SCI contusion group. These results indicate that (1) mild injuries retaining weight-bearing locomotion that should have mild, if any, edema/loss of vascular tone still exhibit severe polyuria, and (2) step training was unable to reduce post-SCI polyuria. Taken together, these results indicate that the current

Macrophage depletion and Schwann cell transplantation reduce cyst size after rat contusive spinal cord injury.

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Lee, Yee-Shuan; Funk, Lucy H; Lee, Jae K; Bunge, Mary Bartlett

2018-04-01

Schwann cell transplantation is a promising therapy for the treatment of spinal cord injury (SCI) and is currently in clinical trials. In our continuing efforts to improve Schwann cell transplantation strategies, we sought to determine the combined effects of Schwann cell transplantation with macrophage depletion. Since macrophages are major inflammatory contributors to the acute spinal cord injury, and are the major phagocytic cells, we hypothesized that transplanting Schwann cells after macrophage depletion will improve cell survival and integration with host tissue after SCI. To test this hypothesis, rat models of contusive SCI at thoracic level 8 were randomly subjected to macrophage depletion or not. In rat subjected to macrophage depletion, liposomes filled with clodronate were intraperitoneally injected at 1, 3, 6, 11, and 18 days post injury. Rats not subjected to macrophage depletion were intraperitoneally injected with liposomes filled with phosphate buffered saline. Schwann cells were transplanted 1 week post injury in all rats. Biotinylated dextran amine (BDA) was injected at thoracic level 5 to evalute axon regeneration. The Basso, Beattie, and Bresnahan locomotor test, Gridwalk test, and sensory test using von Frey filaments were performed to assess functional recovery. Immunohistochemistry was used to detect glial fibrillary acidic protein, neurofilament, and green fluorescent protein (GFP), and also to visulize BDA-labelled axons. The GFP labeled Schwann cell and cyst and lesion volumes were quantified using stained slides. The numbers of BDA-positive axons were also quantified. At 8 weeks after Schwann cell transplantation, there was a significant reduction in cyst and lesion volumes in the combined treatment group compared to Schwann cell transplantation alone. These changes were not associated, however, with improved Schwann cell survival, axon growth, or locomotor recovery. Although combining Schwann cell transplantation with macrophage

Macrophage depletion and Schwann cell transplantation reduce cyst size after rat contusive spinal cord injury

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Lee, Yee-Shuan; Funk, Lucy H.; Lee, Jae K.; Bunge, Mary Bartlett

2018-01-01

Schwann cell transplantation is a promising therapy for the treatment of spinal cord injury (SCI) and is currently in clinical trials. In our continuing efforts to improve Schwann cell transplantation strategies, we sought to determine the combined effects of Schwann cell transplantation with macrophage depletion. Since macrophages are major inflammatory contributors to the acute spinal cord injury, and are the major phagocytic cells, we hypothesized that transplanting Schwann cells after macrophage depletion will improve cell survival and integration with host tissue after SCI. To test this hypothesis, rat models of contusive SCI at thoracic level 8 were randomly subjected to macrophage depletion or not. In rat subjected to macrophage depletion, liposomes filled with clodronate were intraperitoneally injected at 1, 3, 6, 11, and 18 days post injury. Rats not subjected to macrophage depletion were intraperitoneally injected with liposomes filled with phosphate buffered saline. Schwann cells were transplanted 1 week post injury in all rats. Biotinylated dextran amine (BDA) was injected at thoracic level 5 to evalute axon regeneration. The Basso, Beattie, and Bresnahan locomotor test, Gridwalk test, and sensory test using von Frey filaments were performed to assess functional recovery. Immunohistochemistry was used to detect glial fibrillary acidic protein, neurofilament, and green fluorescent protein (GFP), and also to visulize BDA-labelled axons. The GFP labeled Schwann cell and cyst and lesion volumes were quantified using stained slides. The numbers of BDA-positive axons were also quantified. At 8 weeks after Schwann cell transplantation, there was a significant reduction in cyst and lesion volumes in the combined treatment group compared to Schwann cell transplantation alone. These changes were not associated, however, with improved Schwann cell survival, axon growth, or locomotor recovery. Although combining Schwann cell transplantation with macrophage

Macrophage depletion and Schwann cell transplantation reduce cyst size after rat contusive spinal cord injury

Directory of Open Access Journals (Sweden)

Yee-Shuan Lee

2018-01-01

Full Text Available Schwann cell transplantation is a promising therapy for the treatment of spinal cord injury (SCI and is currently in clinical trials. In our continuing efforts to improve Schwann cell transplantation strategies, we sought to determine the combined effects of Schwann cell transplantation with macrophage depletion. Since macrophages are major inflammatory contributors to the acute spinal cord injury, and are the major phagocytic cells, we hypothesized that transplanting Schwann cells after macrophage depletion will improve cell survival and integration with host tissue after SCI. To test this hypothesis, rat models of contusive SCI at thoracic level 8 were randomly subjected to macrophage depletion or not. In rat subjected to macrophage depletion, liposomes filled with clodronate were intraperitoneally injected at 1, 3, 6, 11, and 18 days post injury. Rats not subjected to macrophage depletion were intraperitoneally injected with liposomes filled with phosphate buffered saline. Schwann cells were transplanted 1 week post injury in all rats. Biotinylated dextran amine (BDA was injected at thoracic level 5 to evalute axon regeneration. The Basso, Beattie, and Bresnahan locomotor test, Gridwalk test, and sensory test using von Frey filaments were performed to assess functional recovery. Immunohistochemistry was used to detect glial fibrillary acidic protein, neurofilament, and green fluorescent protein (GFP, and also to visulize BDA-labelled axons. The GFP labeled Schwann cell and cyst and lesion volumes were quantified using stained slides. The numbers of BDA-positive axons were also quantified. At 8 weeks after Schwann cell transplantation, there was a significant reduction in cyst and lesion volumes in the combined treatment group compared to Schwann cell transplantation alone. These changes were not associated, however, with improved Schwann cell survival, axon growth, or locomotor recovery. Although combining Schwann cell transplantation with

Application of multislice spiral CT in children urinary tract injuries

International Nuclear Information System (INIS)

Feng Hui; Chen Jing

2012-01-01

Objective: To investigate the application value of three-dimensional reconstruction technique of multislice spiral CT(MSCT) in children urinary tract injuries. Methods: Forty-three patients with urinary tract injury performed MSCT scan, and three-dimensional reconstruction technique was used for volume rendering, maximum intensity projection and multi-planar reformation, urinary tract imaging was acquired completely. The images were reviewed by two experienced radiologists. Results: Of the 43 cases,there were 5 simple contusion of kidney, 5 contusion and laceration of kidney accompanied with subcapsular haematoma, 4 contusion and laceration of kidney accompanied with perinephric haematoma, 2 contusion and laceration of kidney accompanied with adrenal haematoma, 13 shattered kidney accompanied with extravasation of urine, 3 shattered kidney accompanied with renal pedicle injury, 6 shattered kidney accompanied with ureter injury, 2 pelvic fracture accompanied with posterior urethra split, 3 contusion of urinary bladder wall accompanied with blood clot in the urinary bladder. Conclusion: MSCT has the characteristic of high scanning speed, wide overlay scope,high image quality and thin slice scan. It is an effective modality in the evaluation of children urinary tract injuries. (authors)

Myocardial contusion following nonfatal blunt chest trauma

International Nuclear Information System (INIS)

Kumar, S.A.; Puri, V.K.; Mittal, V.K.; Cortez, J.

1983-01-01

Currently available diagnostic techniques for myocardial contusion following blunt chest trauma were evaluated. We investigated 30 patients prospectively over a period of 1 year for the presence of myocardial contusion. Among the 30 patients, eight were found to have myocardial contusion on the basis of abnormal electrocardiograms, elevated creatine phosphokinase MB fraction (CPK-MB), and positive myocardial scan. Myocardial scan was positive in seven of eight patients (87.5%). CPK-MB fraction was elevated in four of eight patients (50%). Definitive electrocardiographic changes were seen in only two of eight patients (25%). It appears that myocardial scan using technetium pyrophosphate and CPK-MB fraction determinations are the most reliable aids in diagnosis of myocardial contusion following blunt chest trauma

Altered Patterns of Reflex Excitability, Balance, and Locomotion Following Spinal Cord Injury (SCI and Locomotor Training.

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Prodip K Bose

2012-07-01

Full Text Available Spasticity is an important problem that complicates daily living in many individuals with SCI. While previous studies in human and animals revealed significant improvements in locomotor ability with treadmill locomotor training, it is not known to what extent locomotor training influences spasticity. In addition, it would be of considerable practical interest to know how the more ergonomically feasible cycle training compares with treadmill training as therapy to manage SCI-induced spasticity and to improve locomotor function. Our present studies were initiated to evaluate the influence of different types of locomotor training on measures of limb spasticity, gait, and reflex components that contribute to locomotion. For these studies, thirty animals received midthoracic SCI using the standard MASCIS protocol (10 g 2.5 cm weight drop. They were divided randomly into three equal groups: control (contused untrained, contused treadmill trained, and contused cycle trained. Velocity-dependent ankle torque was tested across a wide range of velocities (612 – 49 deg/sec to permit quantitation of tonic (low velocity and dynamic (high velocity contributions to lower limb spasticity. Treadmill and cycle training were started on post-injury day 8. By post-injury weeks 4 and 6, the untrained group revealed significant velocity-dependent ankle extensor spasticity, compared to pre-surgical control values. At these post-injury time points, spasticity was not observed in either of the two training groups. Instead, a significantly milder form of velocity dependent spasticity was detected at postcontusion week 8 through 12 in both treadmill and bicycle training groups at the four fastest ankle rotation velocities (350 - 612 deg/sec. Locomotor training using treadmill or bicycle also produced significant increase in the rate of recovery of limb placement measures (limb axis, base of support, and BBB and reflex rate depression, a quantitative assessment of

Computed tomography for sequelae of brain contusions

International Nuclear Information System (INIS)

Aminov, M.

1995-01-01

Follow-up clinical and computed tomographic (CT) studies were performed in 140 patients with focal brain contusions at the acute stage of brain injury (BI). A total of 133 victims were followed up and the time course of CT changes were examined in the intervening and late BI periods. Despite the favourable natural history of acute BI, mild, moderate, and severe posttraumatic changes were shown to appear as cicatricial-adhesive and atrophic processes, intracerebral cysts, porencephalies, which result in posttraumatic epilepsy, hydrocephalus and others. The magnitude of diffuse changes rather than focal changes in the area of the prior medullary lesion was found to play the leading role in the victims disability [ru

Changes of cerebral blood flow during the secondary expansion of a cortical contusion assessed by 14C-iodoantipyrine autoradiography in mice using a non-invasive protocol.

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Engel, Doortje C; Mies, Günter; Terpolilli, Nicole A; Trabold, Raimund; Loch, Alexander; De Zeeuw, Chris I; Weber, John T; Maas, Andrew I R; Plesnila, Nikolaus

2008-07-01

Although changes of cerebral blood flow (CBF) in and around traumatic contusions are well documented, the role of CBF for the delayed death of neuronal cells in the traumatic penumbra ultimately resulting in secondary contusion expansion remains unclear. The aim of the current study was therefore to investigate the relationship between changes of CBF and progressive peri-contusional cell death following traumatic brain injury (TBI). CBF and contusion size were measured in C57Bl6 mice under continuous on-line monitoring of (ETp)CO2 before, and at 15 min and 24 h following controlled cortical impact by 14C-iodoantipyrine autoradiography (IAP-AR; n = 5-6 per group) and by Nissl staining, respectively. Contused and ischemic (CBF < 10%) tissue volumes were calculated and compared over time. Cortical CBF in not injured mice varied between 69 and 93 mL/100mg/min depending on the anatomical location. Fifteen minutes after trauma, CBF decreased in the whole brain by approximately 50% (39 +/- 18 mL/100mg/min; p < 0.05), except in contused tissue where it fell by more than 90% (3 +/- 2 mL/100mg/min; p < 0.001). Within 24 h after TBI, CBF recovered to normal values in all brain areas except the contusion where it remained reduced by more than 90% (p < 0.001). Contusion volume expanded from 24.9 to 35.5 mm3 (p < 0.01) from 15 min to 24 h after trauma (+43%), whereas the area of severe ischemia (CBF < 10%) showed only a minimal (+13%) and not significant increase (22.3 to 25.1 mm3). The current data therefore suggest that the delayed secondary expansion of a cortical contusion following traumatic brain injury may not be caused by a reduction of CBF alone.

Technique of ICP monitored stepwise intracranial decompression effectively reduces postoperative complications of severe bifrontal contusion

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Guan eSun

2016-04-01

Full Text Available Background Bifrontal contusion is a common clinical brain injury. In the early stage, it is often mild, but it progresses rapidly and frequently worsens suddenly. This condition can become life threatening and therefore requires surgery. Conventional decompression craniectomy is the commonly used treatment method. In this study, the effect of ICP monitored stepwise intracranial decompression surgery on the prognosis of patients with acute severe bifrontal contusion was investigated. Method A total of 136 patients with severe bifrontal contusion combined with deteriorated intracranial hypertension admitted from March 2001 to March 2014 in our hospital were selected and randomly divided into two groups, i.e., a conventional decompression group and an intracranial pressure (ICP monitored stepwise intracranial decompression group (68 patients each, to conduct a retrospective study. The incidence rates of acute intraoperative encephalocele, delayed hematomas, and postoperative cerebral infarctions and the Glasgow outcome scores (GOSs 6 months after the surgery were compared between the two groups.Results (1 The incidence rates of acute encephalocele and contralateral delayed epidural hematoma in the stepwise decompression surgery group were significantly lower than those in the conventional decompression group; the differences were statistically significant (P < 0.05; (2 6 months after the surgery, the incidence of vegetative state and mortality in the stepwise decompression group were significantly lower than those in the conventional decompression group (P < 0.05; the rate of favorable prognosis in the stepwise decompression group was also significantly higher than that in the conventional decompression group (P < 0.05.Conclusions The ICP monitored stepwise intracranial decompression technique reduced the perioperative complications of traumatic brain injury through the gradual release of intracranial pressure and was beneficial to the prognosis of

Computerized tomography in diagnosis of cerebrocranial injury

International Nuclear Information System (INIS)

Kornienko, V.N.; Vasin, N.Ya.; Kuz'menko, V.A.

1987-01-01

The method of computerized tomographical examination are presented. Th KT-characters of concussion of the brain, its contusion of different severity, compressions in case of traumatic intracranial hematomas, contusion injuries, brain edema and different aftereffects of cerebrocranial injury are given. On the basis of comparison of the data of clinical and KT examination the dynamics of intracranial traumatic injuries in the course of treatment is described. The problems of therapeutic and surgical tactics depending on the degree and form of intracranial structure injuries and the phase of clinical course of posttraumatic process are discussed

Utility of MR imaging in pediatric spinal cord injury

International Nuclear Information System (INIS)

Felsberg, G.J.; Tien, R.D.; Osumi, A.K.; Cardenas, C.A.

1995-01-01

We evaluated the utility of MR imaging in pediatric patients with acute and subacute spinal cord injuries. MR imaging of 22 pediatric patients with suspected traumatic spinal cord injuries was reviewed. MR findings were correlated with physical examination and compared to available radiographs and CT examinations performed at time of presentation. Twelve patients had abnormalities on MR imaging. Seven had spinal cord contusions; five contusions were hemorrhagic. Five of seven patients with cord contusion had normal radiographs and CT exams. Six patients with normal radiographs and CT examinations had abnormal MR studies revealing cord contusion, ligamentous injury, disc herniation, and epidural hematoma. MR is useful in initial evaluation of pediatric patients with spinal cord injuries and in prognosis of future neurologic function. In the setting of spinal cord symptomatology and negative radiographic studies, MR imaging should be performed. Surgically correctable causes of cord compression demonstrated by MR imaging include disc herniation, epidural hematoma, and retropulsed fracture fragments. The entity of spinal cord injury without radiographic abnormality is a diagnosis of exclusion which should only be made after radiologic investigation with radiographs, high-resolution thin-section CT, and MR imaging. (orig.)

Clinical value of diffusion-weighted MR imaging in acute contusion of spinal cord

International Nuclear Information System (INIS)

Zhang Jinsong; Huan Yi; Sun Lijun; Zhao Haitao; Ge Yali; Chang Yingjuan; Yang Chunmin

2005-01-01

Objective: To study the clinical value of diffusion-weighted MR imaging (DWI) in acute contusion of spinal cord. Methods: Eighteen cases with acute contusion of spinal cord were examined with routine MRI and DWI, including single-shot DWI (ssh-DWI) in 2 cases and multi-shot DWI (msh-DWI) in 16 cases, on a 1.5-tesla MR system within 72 h post-trauma. Results: Two cases examined by ssh-DWI showed local lesions with significant high signals, but ssh-DWI images could not be used to measure apparent diffusion coefficient (ADC) value due to its weak resolution. Other 16 cases examined by msh-DWI showed better images and were classified into three categories depending on different degrees of tissue injury and characteristics of DWI: (1) Edema-type: ten cases presented DWI high signals with different degree in local lesions. There were significant difference of ADC values between lesions and normal parts (t=7.515, P 2 WI heterogeneous high signals and T 1 WI low signals due to prominent hemorrhage. Conclusion: DWI of the spinal cord provided satisfactory images and was a useful method for visualizing the injury cord in the super-early stage, helping determine integrity and compression degree of spinal cord and detecting hemorrhage. (authors)

Panax ginseng Improves Functional Recovery after Contusive Spinal Cord Injury by Regulating the Inflammatory Response in Rats: An In Vivo Study

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Young Ock Kim

2015-01-01

Full Text Available Spinal cord injury (SCI results in permanent loss of motor function below the injured site. Neuroinflammatory reaction following SCI can aggravate neural injury and functional impairment. Ginseng is well known to possess anti-inflammatory effects. The present study investigated the neuroprotective effects of Panax ginseng C.A. Mayer (P. ginseng after SCI. A spinal contusion was made at the T11-12 spinal cord in adult male Sprague-Dawley rats (n=47 using the NYU impactor. Motor function was assessed using the Basso-Beattie-Bresnahan (BBB score in P. ginseng (0.1, 0.5, 1, 3, and 5 mg/kg or vehicle (saline treated after SCI. We also assessed the protein expression of cyclooxygenase-2 (COX-2 and inducible nitric oxide synthase (iNOS at the lesion site by western blot and then measured the cavity area using luxol fast blue/cresyl violet staining. P. ginseng treated group in SCI showed a significant improvement in locomotor function after the injury. The protein expression of COX-2 and iNOS at the lesion site and the cavity area were decreased following SCI by P. ginseng treatment. These results suggest that P. ginseng may improve the recovery of motor function after SCI which provides neuroprotection by alleviating posttraumatic inflammatory responses.

Clonidine reduces norepinephrine and improves bone marrow function in a rodent model of lung contusion, hemorrhagic shock, and chronic stress.

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Alamo, Ines G; Kannan, Kolenkode B; Ramos, Harry; Loftus, Tyler J; Efron, Philip A; Mohr, Alicia M

2017-03-01

Propranolol has been shown previously to restore bone marrow function and improve anemia after lung contusion/hemorrhagic shock. We hypothesized that daily clonidine administration would inhibit central sympathetic outflow and restore bone marrow function in our rodent model of lung contusion/hemorrhagic shock with chronic stress. Male Sprague-Dawley rats underwent 6 days of restraint stress after lung contusion/hemorrhagic shock during which the animals received clonidine (75 μg/kg) after the restraint stress. On postinjury day 7, we assessed urine norepinephrine, blood hemoglobin, plasma granulocyte colony stimulating factor, and peripheral blood mobilization of hematopoietic progenitor cells, as well as bone marrow cellularity and erythroid progenitor cell growth. The addition of clonidine to lung contusion/hemorrhagic shock with chronic restraint stress significantly decreased urine norepinephrine levels, improved bone marrow cellularity, restored erythroid progenitor colony growth, and improved hemoglobin (14.1 ± 0.6 vs 10.8 ± 0.6 g/dL). The addition of clonidine to lung contusion/hemorrhagic shock with chronic restraint stress significantly decreased hematopoietic progenitor cells mobilization and restored granulocyte colony stimulating factor levels. After lung contusion/hemorrhagic shock with chronic restraint stress, daily administration of clonidine restored bone marrow function and improved anemia. Alleviating chronic stress and decreasing norepinephrine is a key therapeutic target to improve bone marrow function after severe injury. Copyright © 2016 Elsevier Inc. All rights reserved.

Combining glial cell line-derived neurotrophic factor gene delivery (AdGDNF) with L-arginine decreases contusion size but not behavioral deficits after traumatic brain injury.

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Degeorge, M L; Marlowe, D; Werner, E; Soderstrom, K E; Stock, M; Mueller, A; Bohn, M C; Kozlowski, D A

2011-07-27

Our laboratory has previously demonstrated that viral administration of glial cell line-derived neurotrophic factor (AdGDNF), one week prior to a controlled cortical impact (CCI) over the forelimb sensorimotor cortex of the rat (FL-SMC) is neuroprotective, but does not significantly enhance recovery of sensorimotor function. One possible explanation for this discrepancy is that although protected, neurons may not have been functional due to enduring metabolic deficiencies. Additionally, metabolic events following TBI may interfere with expression of therapeutic proteins administered to the injured brain via gene therapy. The current study focused on enhancing the metabolic function of the brain by increasing cerebral blood flow (CBF) with l-arginine in conjunction with administration of AdGDNF immediately following CCI. An adenoviral vector harboring human GDNF was injected unilaterally into FL-SMC of the rat immediately following a unilateral CCI over the FL-SMC. Within 30min of the CCI and AdGDNF injections, some animals were injected with l-arginine (i.v.). Tests of forelimb function and asymmetry were administered for 4weeks post-injury. Animals were sacrificed and contusion size and GDNF protein expression measured. This study demonstrated that rats treated with AdGDNF and l-arginine post-CCI had a significantly smaller contusion than injured rats who did not receive any treatment, or injured rats treated with either AdGDNF or l-arginine alone. Nevertheless, no amelioration of behavioral deficits was seen. These findings suggest that AdGDNF alone following a CCI was not therapeutic and although combining it with l-arginine decreased contusion size, it did not enhance behavioral recovery. Copyright © 2011 Elsevier B.V. All rights reserved.

Injuries in mountain biking.

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Gaulrapp, H; Weber, A; Rosemeyer, B

2001-01-01

Despite still growing attraction mountain biking as a matter of sports traumatology still lacks relevant data based on large cross-sectional surveys. To obtain an overview of risk factors, types, and main body sites of injuries occurring in mountain biking we assessed the results of a questionnaire answered by 3873 athletes. A total of 8133 single lesions were reported by 3474 athletes, 36% of whom regularly participated in competitions. The incidence of injuries in mountain biking is comparable to that in other outdoor sports, the majority of injuries being minor. Mountain biking athletes were found to have an overall injury risk rate of 0.6% per year and 1 injury per 1000 h of biking. The main risk factors included slippery road surface, cyclist's poor judgement of the situation, and excessive speed, representing personal factors that could be altered by preventive measures. Of all injuries 14% were due to collision with some part of the bike, especially the pedals and the handlebar. While 75% of the injuries were minor, such as skin wounds and simple contusions, 10% were so severe that hospitalization was required. A breakdown of the injuries according to body site and frequency of occurrence is presented.

Assessment of the neuroprotective effects of Lavandula angustifolia extract on the contusive model of spinal cord injury in Wistar rats

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Gholamreza eKaka

2016-02-01

Full Text Available IntroductionSpinal cord injury (SCI involves a primary trauma and secondary cellular processes that can lead to severe damage to the nervous system, resulting in long-term spinal deficits. At the cellular level, SCI causes astrogliosis, of which glial fibrillary acidic protein (GFAP is a major index. ObjectiveThe aim of this study was to investigate the neuroprotective effects of Lavandula angustifolia (Lav on the repair of spinal cord injuries in Wistar rats.Materials and MethodsForty-five female rats were randomly divided into six groups of seven rats each: the intact, sham, control (SCI, Lav 100, Lav 200, and Lav 400 groups. Every week after SCI onset, all animals were evaluated for behavior outcomes by the Basso, Beattie, and Bresnahan (BBB score. H&E staining was performed to examine the lesions post-injury. GFAP expression was assessed for astrogliosis. Somatosensory evoked potential (SEP testing was performed to detect the recovery of neural conduction.Results BBB scores were significantly increased and delayed responses on sensory tests were significantly decreased in the Lav 200 and Lav 400 groups compared to the control group. The greatest decrease of GFAP was evident in the Lav 200 and Lav 400 groups. EMG results showed significant improvement in the hindlimbs in the Lav 200 and Lav 400 groups compared to the control group. Cavity areas significantly decreased and the number of ventral motor neurons significantly increased in the Lav 200 and Lav 400 groups.ConclusionLav at doses of 200 mg/kg and 400 mg/kg can promote structural and functional recovery after SCI. The neuroprotective effects of L. angustifolia can lead to improvement in the contusive model of spinal cord injury in Wistar rats.Keywords Spinal cord injury (SCI; Lavandula angustifolia; neuroprotection; Basso, Beattie, and Bresnahan (BBB; glial fibrillary acidic protein (GFAP; somatosensory evoked potential (SEP

Time-dependent gene expression analysis after mouse skeletal muscle contusion

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Weihua Xiao

2016-03-01

Conclusion: The sequence of immune cells invaded after muscle contusion was neutrophils, M1 macrophages and M2 macrophages. Some CC (CCL2, CCL3, and CCL4 and CXC (CXCL10 chemokines may be involved in the chemotaxis of these immune cells. HGF may be the primary factor to activate the satellite cells after muscle contusion. Moreover, 2 weeks are needed to recover when acute contusion happens as used in this study.

High-speed video analysis improves the accuracy of spinal cord compression measurement in a mouse contusion model.

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Fournely, Marion; Petit, Yvan; Wagnac, Éric; Laurin, Jérôme; Callot, Virginie; Arnoux, Pierre-Jean

2018-01-01

Animal models of spinal cord injuries aim to utilize controlled and reproducible conditions. However, a literature review reveals that mouse contusion studies using equivalent protocols may show large disparities in the observed impact force vs. cord compression relationship. The overall purpose of this study was to investigate possible sources of bias in these measurements. The specific objective was to improve spinal cord compression measurements using a video-based setup to detect the impactor-spinal cord time-to-contact. A force-controlled 30kDyn unilateral contusion at C4 vertebral level was performed in six mice with the Infinite Horizon impactor (IH). High-speed video was used to determine the time-to-contact between the impactor tip and the spinal cord and to compute the related displacement of the tip into the tissue: the spinal cord compression and the compression ratio. Delayed time-to-contact detection with the IH device led to an underestimation of the cord compression. Compression values indicated by the IH were 64% lower than those based on video analysis (0.33mm vs. 0.88mm). Consequently, the mean compression ratio derived from the device was underestimated when compared to the value derived from video analysis (22% vs. 61%). Default time-to-contact detection from the IH led to significant errors in spinal cord compression assessment. Accordingly, this may explain some of the reported data discrepancies in the literature. The proposed setup could be implemented by users of contusion devices to improve the quantative description of the primary injury inflicted to the spinal cord. Copyright © 2017 Elsevier B.V. All rights reserved.

Longitudinal study on diffusion tensor imaging and diffusion tensor tractography following spinal cord contusion injury in rats.

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Zhao, Can; Rao, Jia-Sheng; Pei, Xiao-Jiao; Lei, Jian-Feng; Wang, Zhan-Jing; Yang, Zhao-Yang; Li, Xiao-Guang

2016-06-01

Diffusion tensor imaging (DTI) as a potential technology has been used in spinal cord injury (SCI) studies, but the longitudinal evaluation of DTI parameters after SCI, and the correlation between DTI parameters and locomotor outcomes need to be defined. Adult Wistar rats (n = 6) underwent traumatic thoracic cord contusion by an NYU impactor. DTI and Basso-Beattie-Bresnahan datasets were collected pre-SCI and 1, 3, 7, 14, and 84 days post-SCI. Diffusion tensor tractography (DTT) of the spinal cord was also generated. Fractional anisotropy (FA) and connection rate of fibers at the injury epicenter and at 5 mm rostral/caudal to the epicenter were calculated. The variations of these parameters after SCI were observed by one-way analysis of variance and the correlations between these parameters and motor function were explored by Pearson's correlation. FA at the epicenter decreased most remarkably on day 1 post-SCI (from 0.780 ± 0.012 to 0.330 ± 0.015), and continued to decrease slightly by day 3 post-SCI (0.313 ± 0.015), while other parameters decreased significantly over the first 3 days after SCI. DTT showed residual fibers concentrated on ventral and ventrolateral sides of the cord. Moreover, FA at the epicenter exhibited the strongest correlation (r = 0.887, p = 0.000) with the locomotion performance. FA was sensitive to degeneration in white matter and DTT could directly reflect the distribution of the residual white matter. Moreover, days 1 to 3 post-SCI may be the optimal time window for SCI examination and therapy.

Identifying the Long-Term Role of Inducible Nitric Oxide Synthase after Contusive Spinal Cord Injury Using a Transgenic Mouse Model

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Dominic M. Maggio

2017-01-01

Full Text Available Inducible nitric oxide synthase (iNOS is a potent mediator of oxidative stress during neuroinflammation triggered by neurotrauma or neurodegeneration. We previously demonstrated that acute iNOS inhibition attenuated iNOS levels and promoted neuroprotection and functional recovery after spinal cord injury (SCI. The present study investigated the effects of chronic iNOS ablation after SCI using inos-null mice. iNOS−/− knockout and wild-type (WT control mice underwent a moderate thoracic (T8 contusive SCI. Locomotor function was assessed weekly, using the Basso Mouse Scale (BMS, and at the endpoint (six weeks, by footprint analysis. At the endpoint, the volume of preserved white and gray matter, as well as the number of dorsal column axons and perilesional blood vessels rostral to the injury, were quantified. At weeks two and three after SCI, iNOS−/− mice exhibited a significant locomotor improvement compared to WT controls, although a sustained improvement was not observed during later weeks. At the endpoint, iNOS−/− mice showed significantly less preserved white and gray matter, as well as fewer dorsal column axons and perilesional blood vessels, compared to WT controls. While short-term antagonism of iNOS provides histological and functional benefits, its long-term ablation after SCI may be deleterious, blocking protective or reparative processes important for angiogenesis and tissue preservation.

Traumatic brain injury in children in Denmark: A national 15-year study

International Nuclear Information System (INIS)

Engberg, Aase; Teasdale, Thomas W.

1998-01-01

Demographic trends are reported concerning three types of traumatic brain injury (concussions, cranial fractures, and intracranial contusions/ haemorrhages) among children in Denmark of ages up to and including 14 years, for a fifteen year period from 1979 through 1993. The data were derived from a national computer-based hospitalization register and include 49,594 children, of whom 60% were boys and 89% had suffered a concussion. Virtually all injuries were the result of accidents. A major finding was that there has been a general decline in the incidence of traumatic brain injuries, especially for boys from 5 to 14 years old, suggesting a degree of success in preventive measures, particularly regarding road safety. The incidence of fatal cases of intracranial contusions/haemorrhages approximately halved over the 15 year period. However, as a proportion of all diagnosed cases, mortality from intracranial contusions/haemorrhages remained fairly constant at about 22%, perhaps because there have been no markedly successful innovations in acute care. Among children surviving a intracranial contusions/haemorrhages, rather considerable numbers were found to have been awarded disability pension at ages under 30

[Gymnastic school sport injuries--aspects of preventive measures].

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Knobloch, K; Jagodzinski, M; Haasper, C; Zeichen, J; Krettek, C

2006-06-01

Gymnastic school sport injuries account for a significant morbidity and mortality among children and adolescents. Preventive issues may be derived from a thorough in-depth analysis of the pattern and circumstances of gymnastic injuries. During a school year among 3993 schools in 43 889 classes with 993 056 pupils 2234 school sport injuries have been reported to the Gemeinde Unfall Versicherung (GUV) Niedersachsen, Germany. Gymnastic sport injuries account for 18 % (403 accidents), which is second after ball sports injuries. Regarding the distribution of the gymnastic disciplines, vault was the major discipline with 34 %, followed by floor exercise (21.3 %), mini- and competition trampoline (16.8 %), and parallel bars (8.2 %). The analysis of the type of injury during vault accidents revealed contusion (31 %) as the predominant injury, followed by sprains (15.4 %), and fractures (15.4 %). Floor exercise injuries distributed among distorsions (26.7 %), contusions (18.6 %), muscle tears (14 %). Back injuries especially of the cervical and thoracic spine, accounted for 40 % of all their injuries. Minor head injuries account for 4.7 % of all floor exercise injuries. Mini-trampoline injuries distribute among contusions (30 %), fractures (22.5 %), distorsions (7.5 %). 21.8 % collisions were noted against a box in comparison to 6.8 % in case of the horse. Gymnast injuries account for a significant number of all school sport related injuries. Vault and floor exercise account for the vast majority of all injuries, with alarming high numbers of spine injuries during floor exercise and mini-trampoline. A preservation of a high level of attention during a sport lesson, safety measures including appropriate mats and landing zones are mandatory to reduce injuries. Muscle injuries and ankle sprains can be prevented by a prospective proprioceptive training intervention to be implemented in school sports.

Imaging of Combat-Related Thoracic Trauma - Blunt Trauma and Blast Lung Injury.

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Lichtenberger, John P; Kim, Andrew M; Fisher, Dane; Tatum, Peter S; Neubauer, Brian; Peterson, P Gabriel; Carter, Brett W

2018-03-01

Combat-related thoracic trauma (CRTT) is a significant contributor to morbidity and mortality of the casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Penetrating, blunt, and blast injuries are the most common mechanisms of trauma to the chest. Imaging plays a key role in the battlefield management of CRTT casualties. This work discusses the imaging manifestations of thoracic injuries from blunt trauma and blast injury, emphasizing epidemiology and diagnostic clues seen during OEF and OIF. The assessment of radiologic findings in patients who suffer from combat-related blunt thoracic trauma and blast injury is the basis of this work. The imaging modalities for this work include multi-detector computed tomography (MDCT) and chest radiography. Multiple imaging modalities are available to imagers on or near the battlefront, including radiography, fluoroscopy, and MDCT. MDCT with multi-planar reconstructions is the most sensitive imaging modality available in combat hospitals for the evaluation of CRTT. In modern combat, blunt and blast injuries account for a significant portion of CRTT. Individual body armor converts penetrating trauma to blunt trauma, leading to pulmonary contusion that accounted for 50.2% of thoracic injuries during OIF and OEF. Flail chest, a subset of blunt chest injury, is caused by significant blunt force to the chest and occurs four times as frequently in combat casualties when compared with the civilian population. Imaging features of CRTT have significant diagnostic and prognostic value. Pulmonary contusions on chest radiography appear as patchy consolidations in the acute setting with ill-defined and non-segmental borders. MDCT of the chest is a superior imaging modality in diagnosing and evaluating pulmonary contusion. Contusions on MDCT appear as crescentic ground-glass opacities (opacities through which lung interstitium and vasculature are still visible) and areas of consolidation that often do not

Assessment of the Neuroprotective Effects of Lavandula angustifolia Extract on the Contusive Model of Spinal Cord Injury in Wistar Rats

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Kaka, Gholamreza; Yaghoobi, Kayvan; Davoodi, Shaghayegh; Hosseini, Seyed R.; Sadraie, Seyed H.; Mansouri, Korosh

2016-01-01

Introduction: Spinal cord injury (SCI) involves a primary trauma and secondary cellular processes that can lead to severe damage to the nervous system, resulting in long-term spinal deficits. At the cellular level, SCI causes astrogliosis, of which glial fibrillary acidic protein (GFAP) is a major index. Objective: The aim of this study was to investigate the neuroprotective effects of Lavandula angustifolia (Lav) on the repair of spinal cord injuries in Wistar rats. Materials and Methods: Forty-five female rats were randomly divided into six groups of seven rats each: the intact, sham, control (SCI), Lav 100, Lav 200, and Lav 400 groups. Every week after SCI onset, all animals were evaluated for behavior outcomes by the Basso, Beattie, and Bresnahan (BBB) score. H&E staining was performed to examine the lesions post-injury. GFAP expression was assessed for astrogliosis. Somatosensory evoked potential (SEP) testing was performed to detect the recovery of neural conduction. Results: BBB scores were significantly increased and delayed responses on sensory tests were significantly decreased in the Lav 200 and Lav 400 groups compared to the control group. The greatest decrease of GFAP was evident in the Lav 200 and Lav 400 groups. EMG results showed significant improvement in the hindlimbs in the Lav 200 and Lav 400 groups compared to the control group. Cavity areas significantly decreased and the number of ventral motor neurons significantly increased in the Lav 200 and Lav 400 groups. Conclusion: Lav at doses of 200 and 400 mg/kg can promote structural and functional recovery after SCI. The neuroprotective effects of L. angustifolia can lead to improvement in the contusive model of SCI in Wistar rats. PMID:26903793

Baseball and softball injuries.

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Wang, Quincy

2006-05-01

Baseball and softball injuries can be a result of both acute and overuse injuries. Soft tissue injuries include contusions, abrasions, and lacerations. Return to play is allowed when risk of further injury is minimized. Common shoulder injuries include those to the rotator cuff, biceps tendon, and glenoid labrum. Elbow injuries are common in baseball and softball and include medial epicondylitis, ulnar collateral ligament injury, and osteochondritis dissecans. Typically conservative treatment with relative rest, medication, and a rehabilitation program will allow return to play. Surgical intervention may be needed for certain injuries or conservative treatment failure.

Evaluation of dimethyl sulfoxide and dexamethasone on pulmonary contusion in experimental blunt thoracic trauma.

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Boybeyi, Ozlem; Bakar, Bulent; Aslan, Mustafa Kemal; Atasoy, Pinar; Kisa, Ucler; Soyer, Tutku

2014-12-01

A thoracic trauma model was designed to evaluate the effect of dimethyl sulfoxide (DMSO) and dexamethasone (DX) on histopathologic and oxidative changes in lung parenchyma seen after pulmonary contusion. Twenty-four Wistar albino rats were included in the study. They were allocated into control (CG, n=6), sham (SG, n=6), DX (DXG, n=6), and DMSO (DMG, n=6) groups. Only a lung biopsy was performed in CG. In the experimental groups, blunt thoracic trauma was induced by dropping a cylindrical metal weight (0.5 kg) through a stainless steel tube onto the right hemithorax from a height of 0.4 m (E=1.96 J). In the SG, 1 mL of physiologic saline was injected intraperitoneally, in the DXG 10 mg/kg of DX was injected intraperitoneally, and in the DMG 1.2 g/mL of DMSO was injected intraperitoneally 15 minutes after trauma. After 6 hours, lung biopsy was performed for histopathologic and oxidative injury markers. Histopathologically, congestion, hemorrhage, neutrophil infiltration, endothelial-nitric oxide synthase (E-NoS), and total pathologic score were significantly higher in SG, DXG, and DMG when compared with CG (p<0.05). Neutrophil infiltration, total pathologic score, and E-NoS were significantly decreased in DMG when compared with SG and DXG (p<0.05). Biochemically, superoxide dismutase (SOD) level was significantly higher in SG, DXG, and DMG than in CG. SOD level was significantly lower in DXG and DMG than in SG (p<0.05). DMSO prevents further injury by decreasing neutrophil infiltration and endothelial injury in lung contusions. DX may have a role in the progression of inflammation but not in preventing the pathologic disruption of pulmonary parenchyma. Georg Thieme Verlag KG Stuttgart · New York.

Early CT signs of progressive hemorrhagic injury following acute traumatic brain injury

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Tong, Wu-song; Zheng, Ping; Xu, Jun-fa; Guo, Yi-jun; Zeng, Jing-song; Yang, Wen-jin; Li, Gao-yi; He, Bin; Yu, Hui [Pudong New Area People' s Hospital, Department of Neurosurgery, Shanghai (China)

2011-05-15

Since progressive hemorrhagic injury (PHI) was introduced in neurosurgical literatures, several studies have been performed, the results of which have influenced doctors but do not define guidelines for the best treatment of PHI. PHI may be confirmed by a serial computerized tomography (CT) scan, and it has been shown to be associated with a fivefold increase in the risk of clinical worsening and is a significant cause of morbidity and mortality as well. So, early detection of PHI is practically important in a clinical situation. To analyze the early CT signs of progressive hemorrhagic injury following acute traumatic brain injury (TBI) and explore their clinical significances, PHI was confirmed by comparing the first and repeated CT scans. Data were analyzed and compared including times from injury to the first CT and signs of the early CT scan. Logistic regression analysis was used to show the risk factors related to PHI. A cohort of 630 TBI patients was evaluated, and there were 189 (30%) patients who suffered from PHI. For patients with their first CT scan obtained as early as 2 h post-injury, there were 116 (77.25%) cases who suffered from PHI. The differences between PHIs and non-PHIs were significant in the initial CT scans showing fracture, subarachnoid hemorrhage (SAH), brain contusion, epidural hematoma (EDH), subdural hematoma (SDH), and multiple hematoma as well as the times from injury to the first CT scan (P < 0.01). Logistic regression analysis showed that early CT scans (EDH, SDH, SAH, fracture, and brain contusion) were predictors of PHI (P < 0.01). For patients with the first CT scan obtained as early as 2 h post-injury, a follow-up CT scan should be performed promptly. If the initial CT scan shows SAH, brain contusion, and primary hematoma with brain swelling, an earlier and dynamic CT scan should be performed for detection of PHI as early as possible and the medical intervention would be enforced in time. (orig.)

Early CT signs of progressive hemorrhagic injury following acute traumatic brain injury

International Nuclear Information System (INIS)

Tong, Wu-song; Zheng, Ping; Xu, Jun-fa; Guo, Yi-jun; Zeng, Jing-song; Yang, Wen-jin; Li, Gao-yi; He, Bin; Yu, Hui

2011-01-01

Since progressive hemorrhagic injury (PHI) was introduced in neurosurgical literatures, several studies have been performed, the results of which have influenced doctors but do not define guidelines for the best treatment of PHI. PHI may be confirmed by a serial computerized tomography (CT) scan, and it has been shown to be associated with a fivefold increase in the risk of clinical worsening and is a significant cause of morbidity and mortality as well. So, early detection of PHI is practically important in a clinical situation. To analyze the early CT signs of progressive hemorrhagic injury following acute traumatic brain injury (TBI) and explore their clinical significances, PHI was confirmed by comparing the first and repeated CT scans. Data were analyzed and compared including times from injury to the first CT and signs of the early CT scan. Logistic regression analysis was used to show the risk factors related to PHI. A cohort of 630 TBI patients was evaluated, and there were 189 (30%) patients who suffered from PHI. For patients with their first CT scan obtained as early as 2 h post-injury, there were 116 (77.25%) cases who suffered from PHI. The differences between PHIs and non-PHIs were significant in the initial CT scans showing fracture, subarachnoid hemorrhage (SAH), brain contusion, epidural hematoma (EDH), subdural hematoma (SDH), and multiple hematoma as well as the times from injury to the first CT scan (P < 0.01). Logistic regression analysis showed that early CT scans (EDH, SDH, SAH, fracture, and brain contusion) were predictors of PHI (P < 0.01). For patients with the first CT scan obtained as early as 2 h post-injury, a follow-up CT scan should be performed promptly. If the initial CT scan shows SAH, brain contusion, and primary hematoma with brain swelling, an earlier and dynamic CT scan should be performed for detection of PHI as early as possible and the medical intervention would be enforced in time. (orig.)

Papel da dosagem seriada de troponina nos pacientes com suspeita de contusão miocárdica após trauma torácico fechado The role of serial measurement of troponin in patients with a suspected myocardial injury after chest trauma

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Thiago Domingos Corrêa

2007-06-01

myocardial injury troponin I and troponin T have stood out. Troponins are proteins of the citocellular apparatus, released into the bloodstream only after the disruption of myocytes cellular membrane. Therefore they are highly specific to detect myocardial injuries. CONTENTS: We performed a clinical review using the electronic databases MedLine and LILACS from January 1980 to November 2006 about the importance of a serial measurement of troponin I and T as a diagnostic tool as well as predictor of unfavorable clinical outcome in patients with myocardial contusion after a blunt chest trauma. CONCLUSIONS: Although troponins I and T are more specific than usual biomarkers CKMB and CK, these two first biomarkers show a low sensitivity and positive predictive value to diagnosis myocardial contusion. Patients with ECG abnormalities, troponins elevations or both should remain in an intensive care unit (ICU for at least 24 hours, period in which they cam develop most of the complications related to myocardial contusion.

Endogenous stem cell proliferation induced by intravenous hedgehog agonist administration after contusion in the adult rat spinal cord.

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Bambakidis, Nicholas C; Horn, Eric M; Nakaji, Peter; Theodore, Nicholas; Bless, Elizabeth; Dellovade, Tammy; Ma, Chiyuan; Wang, Xukui; Preul, Mark C; Coons, Stephen W; Spetzler, Robert F; Sonntag, Volker K H

2009-02-01

Sonic hedgehog (Shh) is a glycoprotein molecule that upregulates the transcription factor Gli1. The Shh protein plays a critical role in the proliferation of endogenous neural precursor cells when directly injected into the spinal cord after a spinal cord injury in adult rodents. Small-molecule agonists of the hedgehog (Hh) pathway were used in an attempt to reproduce these findings through intravenous administration. The expression of Gli1 was measured in rat spinal cord after the intravenous administration of an Hh agonist. Ten adult rats received a moderate contusion and were treated with either an Hh agonist (10 mg/kg, intravenously) or vehicle (5 rodents per group) 1 hour and 4 days after injury. The rats were killed 5 days postinjury. Tissue samples were immediately placed in fixative. Samples were immunohistochemically stained for neural precursor cells, and these cells were counted. Systemic dosing with an Hh agonist significantly upregulated Gli1 expression in the spinal cord (p < 0.005). After spinal contusion, animals treated with the Hh agonist had significantly more nestin-positive neural precursor cells around the rim of the lesion cavity than in vehicle-treated controls (means +/- SDs, 46.9 +/- 12.9 vs 20.9 +/- 8.3 cells/hpf, respectively, p < 0.005). There was no significant difference in the area of white matter injury between the groups. An intravenous Hh agonist at doses that upregulate spinal cord Gli1 transcription also increases the population of neural precursor cells after spinal cord injury in adult rats. These data support previous findings based on injections of Shh protein directly into the spinal cord.

Lavandula angustifolia Extract Improves the Result of Human Umbilical Mesenchymal Wharton's Jelly Stem Cell Transplantation after Contusive Spinal Cord Injury in Wistar Rats

Science.gov (United States)

Yaghoobi, Kayvan; Kaka, Gholamreza; Mansouri, Korosh; Davoodi, Shaghayegh; Sadraie, Seyed Homayoon; Hosseini, Seyed Ruhollah

2016-01-01

Introduction. The primary trauma of spinal cord injury (SCI) results in severe damage to nervous functions. At the cellular level, SCI causes astrogliosis. Human umbilical mesenchymal stem cells (HUMSCs), isolated from Wharton's jelly of the umbilical cord, can be easily obtained. Previously, we showed that the neuroprotective effects of Lavandula angustifolia can lead to improvement in a contusive SCI model in rats. Objective. The aim of this study was to investigate the effect of L. angustifolia (Lav) on HUMSC transplantation after acute SCI. Materials and Methods. Sixty adult female rats were randomly divided into eight groups. Every week after SCI onset, all animals were evaluated for behavior outcomes. H&E staining was performed to examine the lesions after injury. GFAP expression was assessed for astrogliosis. Somatosensory evoked potential (SEP) testing was performed to detect the recovery of neural conduction. Results. Behavioral tests showed that the HUMSC group improved in comparison with the SCI group, but HUMSC + Lav 400 was very effective, resulting in a significant increase in locomotion activity. Sensory tests and histomorphological and immunohistochemistry analyses verified the potentiation effects of Lav extract on HUMSC treatment. Conclusion. Transplantation of HUMSCs is beneficial for SCI in rats, and Lav extract can potentiate the functional and cellular recovery with HUMSC treatment in rats after SCI. PMID:27057171

Neuroendoscopic Removal of Acute Subdural Hematoma with Contusion: Advantages for Elderly Patients

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Ryota Tamura

2016-01-01

Full Text Available Background. Large craniotomy for acute subdural hematoma is sometimes too invasive. We report good outcomes for two cases of neuroendoscopic evacuation of hematoma and contusion by 1 burr hole surgery. Case Presentation. Both patients arrived by ambulance at our hospital with disturbed consciousness after falling. Case 1 was an 81-year-old man who took antiplatelet drugs for brain infarction. Case 2 was a 73-year-old alcoholic woman. CT scanning showed acute subdural hematoma and frontal contusion in both cases. In the acute stage, glycerol was administered to reduce edema; CTs after 48 and 72 hours showed an increase of subdural hematoma and massive contusion of the frontal lobe. Disturbed consciousness steadily deteriorated. The subdural hematoma and contusion were removed as soon as possible by neuroendoscopy under local anesthesia, because neither patient was a good candidate for large craniotomy considering age and past history. 40%~70% of the hematoma was removed, and the consciousness level improved. Conclusion. Neuroendoscopic removal of acute subdural hematoma and contusion has advantages and disadvantages. For patients with underlying medical issues or other risk factors, it is likely to be effective.

Differential protective effects of motorcycle helmets against head injury.

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Singleton, Michael D

2017-05-19

Although numerous observational studies have demonstrated a protective effect of motorcycle helmets against head injury, the degree of protection against specific head injury types remains unclear. Experimental biomechanics studies involving cadavers, animals, and computer models have established that head injuries have varying etiologies. This retrospective cross-sectional study compared helmet protection against skull fracture, cerebral contusion, intracranial hemorrhage, and cerebral concussion in a consecutive series of motorcycle operators involved in recent traffic crashes in Kentucky. Police collision reports linked to hospital inpatient and emergency department (ED) claims were analyzed for the period 2008 to 2012. Motorcycle operators with known helmet use who were not killed at the crash scene were included in the study. Helmet use was ascertained from the police report. Skull fracture, cerebral contusion, intracranial hemorrhage, and cerebral concussion were identified from International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes on the claims records. The relative risks of each type of head injury for helmeted versus unprotected operators were estimated using generalized estimating equations. Helmets offer substantial protection against skull fracture (relative risk [RR] = 0.31, 95% confidence interval [CI], 0.23, 0.34), cerebral contusion (RR = 0.29, 95% CI, 0.16, 0.53), and intracranial hemorrhage (RR = 0.47, 95% CI, 0.35, 0.63). The findings pertaining to uncomplicated concussion (RR = 0.80, 95% CI, 0.64, 1.01) were inconclusive. A modest protective effect (20% risk reduction) was suggested by the relative risk estimate, but the 95% confidence interval included the null value. Motorcycle helmets were associated with a 69% reduction in skull fractures, 71% reduction in cerebral contusion, and 53% reduction in intracranial hemorrhage. This study finds that current motorcycle helmets do not protect equally against

Apport de l'echographie dans les contusions abdominales de l ...

African Journals Online (AJOL)

Conclusion : l'échographie joue un rôle déterminant dans le bilan lésionnel dans les contusions abdominales, cependant son utilisation reste limitée dans le domaine pédiatrique au CHU SO de Lomé, d'où la nécessité d'une plus large diffusion de cet outil diagnostic. Mots clés : contusion abdominale, enfant, échographie, ...

Delayed expression of cell cycle proteins contributes to astroglial scar formation and chronic inflammation after rat spinal cord contusion

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Wu Junfang

2012-07-01

Full Text Available Abstract Background Traumatic spinal cord injury (SCI induces secondary tissue damage that is associated with astrogliosis and inflammation. We previously reported that acute upregulation of a cluster of cell-cycle-related genes contributes to post-mitotic cell death and secondary damage after SCI. However, it remains unclear whether cell cycle activation continues more chronically and contributes to more delayed glial change. Here we examined expression of cell cycle-related proteins up to 4 months following SCI, as well as the effects of the selective cyclin-dependent kinase (CDKs inhibitor CR8, on astrogliosis and microglial activation in a rat SCI contusion model. Methods Adult male rats were subjected to moderate spinal cord contusion injury at T8 using a well-characterized weight-drop model. Tissue from the lesion epicenter was obtained 4 weeks or 4 months post-injury, and processed for protein expression and lesion volume. Functional recovery was assessed over the 4 months after injury. Results Immunoblot analysis demonstrated a marked continued upregulation of cell cycle-related proteins − including cyclin D1 and E, CDK4, E2F5 and PCNA − for 4 months post-injury that were highly expressed by GFAP+ astrocytes and microglia, and co-localized with inflammatory-related proteins. CR8 administrated systemically 3 h post-injury and continued for 7 days limited the sustained elevation of cell cycle proteins and immunoreactivity of GFAP, Iba-1 and p22PHOX − a key component of NADPH oxidase − up to 4 months after SCI. CR8 treatment significantly reduced lesion volume, which typically progressed in untreated animals between 1 and 4 months after trauma. Functional recovery was also significantly improved by CR8 treatment after SCI from week 2 through week 16. Conclusions These data demonstrate that cell cycle-related proteins are chronically upregulated after SCI and may contribute to astroglial scar

Secondary Insults of Traumatic Brain Injury in CCATT Patients Returning from Iraq/Afghanistan: 2001-2006

Science.gov (United States)

2010-08-31

and hemorrhage. Hemorrhage is further divided into epidural hematoma , subdural hematoma , and intracerebral hematoma . Diffuse brain injuries...fiber Brain Injury Focal Injuries Contusion Laceration Hemorrhage Epidural Hematoma Subdural Hematoma Intracerebral Hematoma Diffuse

Transplantation of oligodendrocyte precursors and sonic hedgehog results in improved function and white matter sparing in the spinal cords of adult rats after contusion.

Science.gov (United States)

Bambakidis, Nicholas C; Miller, Robert H

2004-01-01

A substantial cause of neurological disability in spinal cord injury is oligodendrocyte death leading to demyelination and axonal degeneration. Rescuing oligodendrocytes and preserving myelin is expected to result in significant improvement in functional outcome after spinal cord injury. Although previous investigators have used cellular transplantation of xenografted pluripotent embryonic stem cells and observed improved functional outcome, these transplants have required steroid administration and only a minority of these cells develop into oligodendrocytes. The objective of the present study was to determine whether allografts of oligodendrocyte precursors transplanted into an area of incomplete spinal cord contusion would improve behavioral and electrophysiological measures of spinal cord function. Additional treatment incorporated the use of the glycoprotein molecule Sonic hedgehog (Shh), which has been shown to play a critical role in oligodendroglial development and induce proliferation of endogenous neural precursors after spinal cord injury. Laboratory study. Moderate spinal cord contusion injury was produced in 39 adult rats at T9-T10. Ten animals died during the course of the study. Nine rats served as contusion controls (Group 1). Six rats were treated with oligodendrocyte precursor transplantation 5 days after injury (Group 2). The transplanted cells were isolated from newborn rat pups using immunopanning techniques. Another eight rats received an injection of recombinant Shh along with the oligodendrocyte precursors (Group 3), while six more rats were treated with Shh alone (Group 4). Eight additional rats received only T9 laminectomies to serve as noninjured controls (Group 0). Animals were followed for 28 days. After an initial complete hindlimb paralysis, rats of all groups receiving a contusive injury recovered substantial function within 1 week. By 28 days, rats in Groups 2 and 3 scored 4.7 and 5.8 points better on the Basso, Beattie, Bresnahan

Injury timing alters metabolic, inflammatory and functional outcomes following repeated mild traumatic brain injury.

Science.gov (United States)

Weil, Zachary M; Gaier, Kristopher R; Karelina, Kate

2014-10-01

Repeated head injuries are a major public health concern both for athletes, and members of the police and armed forces. There is ample experimental and clinical evidence that there is a period of enhanced vulnerability to subsequent injury following head trauma. Injuries that occur close together in time produce greater cognitive, histological, and behavioral impairments than do injuries separated by a longer period. Traumatic brain injuries alter cerebral glucose metabolism and the resolution of altered glucose metabolism may signal the end of the period of greater vulnerability. Here, we injured mice either once or twice separated by three or 20days. Repeated injuries that were separated by three days were associated with greater axonal degeneration, enhanced inflammatory responses, and poorer performance in a spatial learning and memory task. A single injury induced a transient but marked increase in local cerebral glucose utilization in the injured hippocampus and sensorimotor cortex, whereas a second injury, three days after the first, failed to induce an increase in glucose utilization at the same time point. In contrast, when the second injury occurred substantially later (20days after the first injury), an increase in glucose utilization occurred that paralleled the increase observed following a single injury. The increased glucose utilization observed after a single injury appears to be an adaptive component of recovery, while mice with 2 injuries separated by three days were not able to mount this response, thus this second injury may have produced a significant energetic crisis such that energetic demands outstripped the ability of the damaged cells to utilize energy. These data strongly reinforce the idea that too rapid return to activity after a traumatic brain injury can induce permanent damage and disability, and that monitoring cerebral energy utilization may be a tool to determine when it is safe to return to the activity that caused the initial

Lavandula angustifolia Extract Improves the Result of Human Umbilical Mesenchymal Wharton’s Jelly Stem Cell Transplantation after Contusive Spinal Cord Injury in Wistar Rats

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Kayvan Yaghoobi

2016-01-01

Full Text Available Introduction. The primary trauma of spinal cord injury (SCI results in severe damage to nervous functions. At the cellular level, SCI causes astrogliosis. Human umbilical mesenchymal stem cells (HUMSCs, isolated from Wharton’s jelly of the umbilical cord, can be easily obtained. Previously, we showed that the neuroprotective effects of Lavandula angustifolia can lead to improvement in a contusive SCI model in rats. Objective. The aim of this study was to investigate the effect of L. angustifolia (Lav on HUMSC transplantation after acute SCI. Materials and Methods. Sixty adult female rats were randomly divided into eight groups. Every week after SCI onset, all animals were evaluated for behavior outcomes. H&E staining was performed to examine the lesions after injury. GFAP expression was assessed for astrogliosis. Somatosensory evoked potential (SEP testing was performed to detect the recovery of neural conduction. Results. Behavioral tests showed that the HUMSC group improved in comparison with the SCI group, but HUMSC + Lav 400 was very effective, resulting in a significant increase in locomotion activity. Sensory tests and histomorphological and immunohistochemistry analyses verified the potentiation effects of Lav extract on HUMSC treatment. Conclusion. Transplantation of HUMSCs is beneficial for SCI in rats, and Lav extract can potentiate the functional and cellular recovery with HUMSC treatment in rats after SCI.

An Epidemiological Investigation of Skiing Injuries in Erciyes Ski Centre

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Gökmen Özen

2017-06-01

Material and Methods: This research was conducted using data that were recorded in the Erciyes Ski Centre Injury Surveillance System from 2012 to 2016 by ski patrols. We calculated the number of skiers from sold lift cards and tickets. A total of 616 cases of skiing injuries were recorded over the four seasons. Results: The calculated injury rate was 2.6 per 1000 skiers in the period of 2012-2016. A total of 372 (60.4% patients were males and 244 were (39.6% females and their mean ages were 27.2 ± 9.8 (range 7-65 years. The most common mechanisms of injuries were falling (82.3 followed by collision (11.5%. Skiing injuries occurred mostly at the lower extremities (52.6%, followed by upper extremities (20.4%.The most frequently seen cases were contusions (59.7% and sprains (12.5%. Conclusion: The rate of injury was compatible with reference ranges (2-4‰ for Erciyes Ski Centre during all seasons. Injuries were seen mostly in adults. The most frequent injuries were at the lower extremities, which were falling-related and contusions. There were no substantial proportional changes in terms of the variables between the seasons.

Manobra de recrutamento alveolar na contusão pulmonar: relato de caso e revisão da literatura Alveolar recruitment in pulmonary contusion: case report and literature review

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Lívia Maria Vitório Trindade

2009-03-01

changes occur as a result of the effects produced by loss of chest wall integrity, accumulation of fluid in the pleural cavity, obstruction of the airways and lung dysfunction. The alveolar recruitment maneuver is the reopening of collapsed lung areas by increasing inspiratory pressure in the airway. The primary objective of this case report was to evaluate the effectiveness of the alveolar recruitment maneuver in a patient with pulmonary contusion. A 33 year old male patient, with a clinical condition of bilateral chest trauma and traumatic brain injury, evolved with reduction of the level of consciousness, acute respiratory failure, hypovolemic shock and hemoptysis. The patient underwent thoracentesis, bilateral thoracic drainage and was also submitted to invasive mechanical ventilation. After 48 hours of invasive mechanical ventilation, in accordance with protective strategy an alveolar recruitment maneuver mode, pressure-controlled ventilation, pressure controlled 10 cmH2O, respiratory rate 10 rpm, inspiratory time 3.0, positive end-expiratory pressure 30 cmH2O and FI0(2 100%, for two minutes. After the alveolar recruitment maneuver, the patient presented clinical pulmonary improvement, but there was a variation of 185 to 322 of Pa0(2/FiO2 (arterial partial pressure of oxygen/ fraction of inspired oxygen. He was discharged from the intensive care unit 22 days after admission. The alveolar recruitment maneuver in this patient showed significant results in the treatment of pulmonary contusion, improving blood oxygenation, preventing alveolar collapse and reversing atelectasis.

Rehabilitation of muscle after injury - the role of anti-inflammatory drugs

DEFF Research Database (Denmark)

Mackey, Abigail; Mikkelsen, U R; Magnusson, S P

2012-01-01

junction, whereas contusion or overload injury can damage both myofibers and intramuscular connective tissue. The role of NSAIDs in muscle repair is complicated by differences in injury models used, variables evaluated, and time point(s) selected for evaluations. While the temporal pattern of the influence...

Regenerated rat skeletal muscle after periodic contusions

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V.B. Minamoto

2001-11-01

Full Text Available In the present study we evaluated the morphological aspect and changes in the area and incidence of muscle fiber types of long-term regenerated rat tibialis anterior (TA muscle previously submitted to periodic contusions. Animals received eight consecutive traumas: one trauma per week, for eight weeks, and were evaluated one (N = 8 and four (N = 9 months after the last contusion. Serial cross-sections were evaluated by toluidine blue staining, acid phosphatase and myosin ATPase reactions. The weight of injured muscles was decreased compared to the contralateral intact one (one month: 0.77 ± 0.15 vs 0.91 ± 0.09 g, P = 0.03; four months: 0.79 ± 0.14 vs 1.02 ± 0.07 g, P = 0.0007, respectively and showed abundant presence of split fibers and fibers with centralized nuclei, mainly in the deep portion. Damaged muscles presented a higher incidence of undifferentiated fibers when compared to the intact one (one month: 3.4 ± 2.1 vs 0.5 ± 0.3%, P = 0.006; four months: 2.3 ± 1.6 vs 0.3 ± 0.3%, P = 0.007, respectively. Injured TA evaluated one month later showed a decreased area of muscle fibers when compared to the intact one (P = 0.003. Thus, we conclude that: a muscle fibers were damaged mainly in the deep portion, probably because they were compressed against the tibia; b periodic contusions in the TA muscle did not change the percentage of type I and II muscle fibers; c periodically injured TA muscles took four months to reach a muscle fiber area similar to that of the intact muscle.

Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle: associated ligament and meniscal tears

International Nuclear Information System (INIS)

Hong, Hyun Pyo; Lee, Jae Gue; Park, Ji Seon; Ryu, Kyung Nam

2004-01-01

Kissing contusion between the posterolateral tibial plateau and lateral femoral condyle is frequently found in association with a tear of the anterior cruciate liagment (ACL). The purpose of this study was to determine which ligamentous and meniscal tears are associated with kissing contusion. We retrospectively reviewed the findings depicted by 323 consecutive MR images of the knee and confirmed at arthroscopy. For the diagnosis of disruption, ligaments, medial menisci (MM) and lateral menisci (LM) were evaluated using accepted criteria. We compared the prevalence and location of meniscal and ligamentous tears between group I (44 knees with kissing contusion) and group II (279 knees without kissing contusion). For statistical analysis the chi-square test was used. ACLs were torn in all 44 knees (100%) with kissing contusion, and 78 (28%) of 279 without kissing contusion. There were ten medial collateral ligament (MCL) tears (23%) in group I, and 17 MCL tears (6%), five lateral collateral ligament (LCL) tears (2%) and ten posterior cruciate ligament (PCL) tears (4%) in group II. In group I, meniscal tears were found in 22 MM (50%) and in 19 LM (43%), while in group II, they occurred in 128 MM (46%) and 128 LM (46%), In group I, 17 (77%) of 22 MM tears and 13 (68%) of 19 LM tears were located in the posterior horn, while in group II, the corresponding figures were 97/128 (76%) and 60 of 128 (47%). The differing prevalence of ACL and MCL tears between the groups was statistically significant (p 0.05). Although kissing contusion was a highly specific sign of ACL tears, its presence was also significant among MCL tears. There was no significant difference in meniscal tears with or without kissing contusion

Alterations in cardiac autonomic control in spinal cord injury.

Science.gov (United States)

Biering-Sørensen, Fin; Biering-Sørensen, Tor; Liu, Nan; Malmqvist, Lasse; Wecht, Jill Maria; Krassioukov, Andrei

2018-01-01

A spinal cord injury (SCI) interferes with the autonomic nervous system (ANS). The effect on the cardiovascular system will depend on the extent of damage to the spinal/central component of ANS. The cardiac changes are caused by loss of supraspinal sympathetic control and relatively increased parasympathetic cardiac control. Decreases in sympathetic activity result in heart rate and the arterial blood pressure changes, and may cause arrhythmias, in particular bradycardia, with the risk of cardiac arrest in those with cervical or high thoracic injuries. The objective of this review is to give an update of the current knowledge related to the alterations in cardiac autonomic control following SCI. With this purpose the review includes the following subheadings: 2. Neuro-anatomical plasticity and cardiac control 2.1 Autonomic nervous system and the heart 2.2 Alteration in autonomic control of the heart following spinal cord injury 3. Spinal shock and neurogenic shock 3.1 Pathophysiology of spinal shock 3.2 Pathophysiology of neurogenic shock 4. Autonomic dysreflexia 4.1 Pathophysiology of autonomic dysreflexia 4.2 Diagnosis of autonomic dysreflexia 5. Heart rate/electrocardiography following spinal cord injury 5.1 Acute phase 5.2 Chronic phase 6. Heart rate variability 6.1 Time domain analysis 6.2 Frequency domain analysis 6.3 QT-variability index 6.4 Nonlinear (fractal) indexes 7. Echocardiography 7.1 Changes in cardiac structure following spinal cord injury 7.2 Changes in cardiac function following spinal cord injury 8. International spinal cord injury cardiovascular basic data set and international standards to document the remaining autonomic function in spinal cord injury. Copyright © 2017 Elsevier B.V. All rights reserved.

An "up, no change, or down" system: Time-dependent expression of mRNAs in contused skeletal muscle of rats used for wound age estimation.

Science.gov (United States)

Sun, Jun-Hong; Zhu, Xi-Yan; Dong, Ta-Na; Zhang, Xiao-Hong; Liu, Qi-Qing; Li, San-Qiang; Du, Qiu-Xiang

2017-03-01

The combined use of multiple markers is considered a promising strategy in estimating the age of wounds. We sought to develop an "up, no change, or down" system and to explore how to combine and use various parameters. In total, 78 Sprague Dawley rats were divided randomly into a control group and contusion groups of 4-, 8-, 12-, 16-, 20-, 24-, 28-, 32-, 36-, 40-, 44-, and 48-h post-injury (n=6 per group). A contusion was produced in the right limb of the rats under diethyl ether anesthesia by a drop-ball technique; the animals were sacrificed at certain time points thereafter, using a lethal dose of pentobarbital. Levels of PUM2, TAB2, GJC1, and CHRNA1 mRNAs were detected in contused muscle using real-time PCR. An up, no change, or down system was developed with the relative quantities of the four mRNAs recorded as black, dark gray, or light gray boxes, representing up-, no change, or down-regulation of the gene of interest during wound repair. The four transcripts were combined and used as a marker cluster for color model analysis of each contusion group. Levels of PUM2, TAB2, and GJC1 mRNAs decreased, whereas that of CHRNA1 increased in wound repair (Psystem was adequate to distinguish most time groups with the color model. Thus, the proposed up, no change, or down system provide the means to determine the minimal periods of early wounds. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Myocardial contusion in patients with blunt chest trauma as evaluated by thallium 201 myocardial scintigraphy

International Nuclear Information System (INIS)

Bodin, L.; Rouby, J.J.; Viars, P.

1988-01-01

Fifty five patients suffering from blunt chest trauma were studied to assess the diagnosis of myocardial contusion using thallium 201 myocardial scintigraphy. Thirty-eight patients had consistent scintigraphic defects and were considered to have a myocardial contusion. All patients with scintigraphic defects had paroxysmal arrhythmias and/or ECG abnormalities. Of 38 patients, 32 had localized ST-T segment abnormalities; 29, ST-T segment abnormalities suggesting involvement of the same cardiac area as scintigraphic defects; 21, echocardiographic abnormalities. Sixteen patients had segmental hypokinesia involving the same cardiac area as the scintigraphic defects. Fifteen patients had clinical signs suggestive of myocardial contusion and scintigraphic defects. Almost 70 percent of patients with blunt chest trauma had scintigraphic defects related to areas of myocardial contusion. When thallium 201 myocardial scintigraphy directly showed myocardial lesion, two-dimensional echocardiography and standard ECG detected related functional consequences of cardiac trauma

body injury rates in adolescent female football players

African Journals Online (AJOL)

All football injuries requiring medical attention (including stiffness, strains, contusions and sprains) and/or the removal from a session, leading to training restriction, were .... This was a descriptive pilot study based on the results of the high-.

The autopsy-correlation of computed tomography in acute severe head injuries

International Nuclear Information System (INIS)

Tomita, Shin; Kim, Hong; Mikabe, Toshio; Karasawa, Hideharu; Watanabe, Saburo

1981-01-01

We discuss the importance of Contrast-Enhanced CT (C.E.CT) in establishing the variety of the intracranial pathological process in acute severe head injuries. During a two-and-a-half-year period (June, 1977 - December, 1979) thirty-three patients with acute severe head injuries were autopsied, all of whom had been scanned on admission. Among them, 14 patients had undergone both plain CT and C.E.CT on admission. Brain slices were examined macroscopically in three categories; brain contusion, subarachnoid hemorrhage, and intracerebral hemorrhage. Each category was then compared retrospectively with the plain CT and C.E.CT findings. C.E.CT was found to correspond much better to the autopsy finding than plain CT in the following three points: (1) C.E.CT clearly enhances the contusion areas and reveals occult contusion areas. (2) C.E.CT enhances the areas corresponding to the subarachnoid space due to the breakdown of brain-surface blood vessels. (3) C.E.CT reveals the enlargement and formation of the intracerebral hematoma by the extravasation of the intravenous contrast material from injured arterial vessels. (author)

Cystourethrographic findings of the lower urinary tract injury

International Nuclear Information System (INIS)

Bae, H. S.; Bae, W. K.; Cho, O. K.

1981-01-01

During the period of 4 years from July, 1976 to June 1980 the radiological and clinical evaluation had been made on 102 patients suffered from lower urinary tract injuries which were confirmed by the radiological examination and operation. The results were as follows: 1. Age distribution of the total 102 patients (87 males and 15 females) was broad from 4 to 72 years. And most of the patient were in the age group of 20 to 49 years. 2. The most common cause of injury was traffic accident (67.6%), next blunt trauma, saddle injury, fall down respectively. 3. 46 patients of bladder injury were as follows: intraperitoneal rupture in 17, extraperitoneal rupture in 12, and contusion in 14. 4. 74 patients of urethral injury were as follows: membranous portion in 37, bulbous portion in 31, prostatic portion in 3, and penile portion in 2. Most of the cases showed extravasation of contrast media. 12 cases showed extravasation with venous intravasation. 5. Contusion or extraperitoneal rupture of the bladder, membranous urethral injury, and concommitent bladder and urethral ruptures were frequently associated with pelvic bone fracture. Intraperitoneal ruptures of the bladder and solitary ruptures of the bulbous urethra were infrequently associated with pelvic bone fracture. 6. Late sequelae of the lower urinary tract injury were stricture, fistula and stone formation

Epidemiology of occupational injury among cleaners in the healthcare sector.

Science.gov (United States)

Alamgir, Hasanat; Yu, Shicheng

2008-09-01

The cleaning profession has been associated with multiple ergonomic and chemical hazards which elevate the risk for occupational injury. This study investigated the epidemiology of occupational injury among cleaners in healthcare work settings in the Canadian province of British Columbia. Incidents of occupational injury among cleaners, resulting in lost time from work or medical care, over a period of 1 year in two healthcare regions were extracted from a standardized operational database and with person-years obtained from payroll data. Detailed analysis was conducted using Poisson regression modeling. A total of 145 injuries were identified among cleaners, with an annual incidence rate of 32.1 per 100 person-years. After adjustment for age, gender, subsector, facility, experience and employment status, Poisson regression models demonstrated that a significantly higher relative risk (RR) of all injury, musculoskeletal injury and cuts was associated with cleaning work in acute care facilities, compared with long-term care facilities. Female cleaners were at a higher RR of all injuries and contusions than male cleaners. A lower risk of all injury and allergy and irritation incidents among part-time or casual workers was found. Cleaners with >10 years of experience were at significantly lower risk for all injury, contusion and allergy and irritation incidents. Cleaners were found to be at an elevated risk of all injury categories compared with healthcare workers in general.

Traumatic injuries: imaging of head injuries

Energy Technology Data Exchange (ETDEWEB)

Besenski, N. [Croatian Institute for Brain Research, Zagreb (Croatia)

2002-06-01

Due to the forces of acceleration, linear translation, as well as rotational and angular acceleration, the brain undergoes deformation and distortion depending on the site of impact of traumatizing force direction, severity of the traumatizing force, and tissue resistance of the brain. Linear translation of accereration in a closed-head injury can run along the shorter diameter of the skull in latero-lateral direction causing mostly extra-axial lesions (subdural hematoma,epidural hematoma, subarachnoidal hemorrhage) or quite pronounced coup and countercoup contusions. Contusions are considerably less frequently present in medial or paramedial centroaxial blows (fronto-occipital or occipito-frontal). The centroaxial blows produce a different pattern of lesions mostly in the deep structures, causing in some cases a special category of the brain injury, the diffuse axonal injury (DAI). The brain stem can also be damaged, but it is damaged more often in patients who have suffered centroaxial traumatic force direction. Computed tomography and MRI are the most common techniques in patients who have suffered brain injury. Computed tomography is currently the first imaging technique to be used after head injury, in those settings where CT is available. Using CT, scalp, bone, extra-axial hematomas, and parenchymal injury can be demonstrated. Computed tomography is rapid and easily performed also in monitored patients. It is the most relevant imaging procedure for surgical lesions. Computed tomography is a suitable method to follow the dynamics of lesion development giving an insight into the corresponding pathological development of the brain injury. Magnetic resonance imaging is more sensitive for all posttraumatic lesions except skull fractures and subarachnoidal hemorrhage, but scanning time is longer, and the problem with the monitoring of patients outside the MRI field is present. If CT does not demonstrate pathology as can adequately be explained to account for

Traumatic injuries: imaging of head injuries

International Nuclear Information System (INIS)

Besenski, N.

2002-01-01

Due to the forces of acceleration, linear translation, as well as rotational and angular acceleration, the brain undergoes deformation and distortion depending on the site of impact of traumatizing force direction, severity of the traumatizing force, and tissue resistance of the brain. Linear translation of accereration in a closed-head injury can run along the shorter diameter of the skull in latero-lateral direction causing mostly extra-axial lesions (subdural hematoma,epidural hematoma, subarachnoidal hemorrhage) or quite pronounced coup and countercoup contusions. Contusions are considerably less frequently present in medial or paramedial centroaxial blows (fronto-occipital or occipito-frontal). The centroaxial blows produce a different pattern of lesions mostly in the deep structures, causing in some cases a special category of the brain injury, the diffuse axonal injury (DAI). The brain stem can also be damaged, but it is damaged more often in patients who have suffered centroaxial traumatic force direction. Computed tomography and MRI are the most common techniques in patients who have suffered brain injury. Computed tomography is currently the first imaging technique to be used after head injury, in those settings where CT is available. Using CT, scalp, bone, extra-axial hematomas, and parenchymal injury can be demonstrated. Computed tomography is rapid and easily performed also in monitored patients. It is the most relevant imaging procedure for surgical lesions. Computed tomography is a suitable method to follow the dynamics of lesion development giving an insight into the corresponding pathological development of the brain injury. Magnetic resonance imaging is more sensitive for all posttraumatic lesions except skull fractures and subarachnoidal hemorrhage, but scanning time is longer, and the problem with the monitoring of patients outside the MRI field is present. If CT does not demonstrate pathology as can adequately be explained to account for

Soccer injuries in children

International Nuclear Information System (INIS)

Paterson, Anne

2009-01-01

Soccer is the most popular sport in the world, with FIFA recognising more than 265 million amateur players. Despite the fact that soccer is a contact sport, it is perceived to be relatively safe to play, a factor that has contributed to its status as the fastest growing team sport in the USA. Acute and minor injuries predominate in the statistics, with contusions and abrasions being the most commonly recorded. As would be expected, the majority of soccer injuries are to the lower limbs, with serious truncal and spinal trauma being rare. This article examines the type and anatomic location of injuries sustained by children and adolescents who play soccer, and the main mechanisms whereby such injuries occur. The risk factors underpinning injury occurrence are considered, along with injury avoidance tactics. (orig.)

Soccer injuries in children

Energy Technology Data Exchange (ETDEWEB)

Paterson, Anne [Royal Belfast Hospital for Sick Children, Radiology Department, Belfast (United Kingdom)

2009-12-15

Soccer is the most popular sport in the world, with FIFA recognising more than 265 million amateur players. Despite the fact that soccer is a contact sport, it is perceived to be relatively safe to play, a factor that has contributed to its status as the fastest growing team sport in the USA. Acute and minor injuries predominate in the statistics, with contusions and abrasions being the most commonly recorded. As would be expected, the majority of soccer injuries are to the lower limbs, with serious truncal and spinal trauma being rare. This article examines the type and anatomic location of injuries sustained by children and adolescents who play soccer, and the main mechanisms whereby such injuries occur. The risk factors underpinning injury occurrence are considered, along with injury avoidance tactics. (orig.)

Soccer injuries in children.

Science.gov (United States)

Paterson, Anne

2009-12-01

Soccer is the most popular sport in the world, with FIFA recognising more than 265 million amateur players. Despite the fact that soccer is a contact sport, it is perceived to be relatively safe to play, a factor that has contributed to its status as the fastest growing team sport in the USA. Acute and minor injuries predominate in the statistics, with contusions and abrasions being the most commonly recorded. As would be expected, the majority of soccer injuries are to the lower limbs, with serious truncal and spinal trauma being rare. This article examines the type and anatomic location of injuries sustained by children and adolescents who play soccer, and the main mechanisms whereby such injuries occur. The risk factors underpinning injury occurrence are considered, along with injury avoidance tactics.

Head injury in children

International Nuclear Information System (INIS)

Sugiura, Makoto; Mori, Nobuhiko; Yokosuka, Reiko; Yamamoto, Masaaki; Imanaga, Hirohisa

1981-01-01

Findings of computerized tomography (CT) in 183 cases of head injury in children were investigated with special reference to CT findings of mild head injury. As was expected, CT findings of mild head injury fell within the normal range, in almost all cases. However, abnormal findings were noticed in 4 out of 34 cases (12%) in acute stage and 7 out of 76 cases (9%) in chronic stage. They were 3 cases of localized low density area in acute stage and 6 cases of mild cerebral atrophy in chronic stage, etc. There were some cases of mild head injury in which CT findings were normal while EEG examination revealed abnormality. Also in some cases, x-ray study demonstrated linear skull fracture which CT failed to show. These conventional techniques could be still remained as useful adjunct aid in diagnosis of head injury. CT findings of cases of cerebral contusion in their acute stage were divided as follows; normal, low density, small ventricle and ventricular and/or cisternal hemorrhage, frequency of incidence being 38, 17, 22, 11% respectively. These findings were invariably converted to cerebral atrophy from 10 days to 2 months after the impacts. In the cases with intracranial hematoma revealed by CT, only 32% of them showed clinical signs of Araki's type IV in their acute stage and 63% of them showed no neurological defects, that is Araki's type I and II. A case of extreme diffuse cerebral atrophy which followed acute subdural hematoma caused by tear of bridging veins without cortical contusion was presented. (author)

Postmortem CT of severe head injuries

International Nuclear Information System (INIS)

Tamura, Masaru; Tsukahara, Yoshio; Nagaseki, Yoshishige; Horikoshi, Satoru; Yodonawa, Masahiko

1983-01-01

CT findings of fatal head injuries were analysed for the cause of death. Postmortem CT examinations were undertaken on 14 cases who died before reaching the hospital or shortly after arrival at the hospital (immediate death group). CT were also examined in non-operative 20 cases who were comatose and who died within 24 hours after severe head injuries (early death group). In the immediate death group, the following findings were demonstrated: a huge amount of free intracranial and intraventricular air in 8 cases; traumatic basal subarachnoid hemorrhage in 3 cases; a mixture of pneumocephalus and subarachnoid hemorrhage in 2 cases, and intracranial hematoma in 1 case. In the early death group: a mixture of pneumocephalus and subarachnoid hemorrhage in 2 cases; traumatic subarachnoid hemorrhage in 5 cases; intracranial hematoma in 11 cases, and brain contusion in 2 cases. The huge amount of intracranial free air due to the severe fracture of the skull base will make the CNS collapse immediately. Basal subarachnoid hemorrhage with signs of brain-stem injuries may result in instantaneous death. Acute subdural hematoma with contusion and edema in elderly patients was the most frequent cause of death in the early death group. (author)

The effectiveness of the anti-CD11d treatment is reduced in rat models of spinal cord injury that produce significant levels of intraspinal hemorrhage.

Science.gov (United States)

Geremia, N M; Hryciw, T; Bao, F; Streijger, F; Okon, E; Lee, J H T; Weaver, L C; Dekaban, G A; Kwon, B K; Brown, A

2017-09-01

We have previously reported that administration of a CD11d monoclonal antibody (mAb) improves recovery in a clip-compression model of SCI. In this model the CD11d mAb reduces the infiltration of activated leukocytes into the injured spinal cord (as indicated by reduced intraspinal MPO). However not all anti-inflammatory strategies have reported beneficial results, suggesting that success of the CD11d mAb treatment may depend on the type or severity of the injury. We therefore tested the CD11d mAb treatment in a rat hemi-contusion model of cervical SCI. In contrast to its effects in the clip-compression model, the CD11d mAb treatment did not improve forelimb function nor did it significantly reduce MPO levels in the hemi-contused cord. To determine if the disparate results using the CD11d mAb were due to the biomechanical nature of the cord injury (compression SCI versus contusion SCI) or to the spinal level of the injury (12th thoracic level versus cervical) we further evaluated the CD11d mAb treatment after a T12 contusion SCI. In contrast to the T12 clip compression SCI, the CD11d mAb treatment did not improve locomotor recovery or significantly reduce MPO levels after T12 contusion SCI. Lesion analyses revealed increased levels of hemorrhage after contusion SCI compared to clip-compression SCI. SCI that is accompanied by increased intraspinal hemorrhage would be predicted to be refractory to the CD11d mAb therapy as this approach targets leukocyte diapedesis through the intact vasculature. These results suggest that the disparate results of the anti-CD11d treatment in contusion and clip-compression models of SCI are due to the different pathophysiological mechanisms that dominate these two types of spinal cord injuries. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Transplantation of adult monkey neural stem cells into a contusion spinal cord injury model in rhesus macaque monkeys

DEFF Research Database (Denmark)

Nemati, Shiva Nemati; Jabbari, Reza; Hajinasrollah, Mostafa

2014-01-01

, therefore, to explore the efficacy of adult monkey NSC (mNSC) in a primate SCI model. MATERIALS AND METHODS: In this experimental study, isolated mNSCs were analyzed by flow cytometry, immunocytochemistry, and RT-PCR. Next, BrdU-labeled cells were transplanted into a SCI model. The SCI animal model...... on Tarlov's scale and our established behavioral tests for monkeys. CONCLUSION: Our findings have indicated that mNSCs can facilitate recovery in contusion SCI models in rhesus macaque monkeys. Additional studies are necessary to determine the im- provement mechanisms after cell transplantation....

A toll-like receptor 9 antagonist improves bladder function and white matter sparing in spinal cord injury.

Science.gov (United States)

David, Brian T; Sampath, Sujitha; Dong, Wei; Heiman, Adee; Rella, Courtney E; Elkabes, Stella; Heary, Robert F

2014-11-01

Spinal cord injury (SCI) affects motor, sensory, and autonomic functions. As current therapies do not adequately alleviate functional deficits, the development of new and more effective approaches is of critical importance. Our earlier investigations indicated that intrathecal administration of a toll-like receptor 9 (TLR9) antagonist, cytidine-phosphate-guanosine oligodeoxynucleotide 2088 (CpG ODN 2088), to mice sustaining a severe, mid-thoracic contusion injury diminished neuropathic pain but did not alter locomotor deficits. These changes were paralleled by a decrease in the pro-inflammatory response at the injury epicenter. Using the same SCI paradigm and treatment regimen, the current studies investigated the effects of the TLR9 antagonist on bladder function. We report that the TLR9 antagonist decreases SCI-elicited urinary retention and ameliorates bladder morphopathology without affecting kidney function. A significant improvement in white matter sparing was also observed, most likely due to alterations in the inflammatory milieu. These findings indicate that the TLR9 antagonist has beneficial effects not only in reducing sensory deficits, but also on bladder dysfunction and tissue preservation. Thus, modulation of innate immune receptor signaling in the spinal cord can impact the effects of SCI.

Topical nonsteroidal anti-inflammatory drugs for the treatment of pain due to soft tissue injury: diclofenac epolamine topical patch

Directory of Open Access Journals (Sweden)

David R Lionberger

2010-11-01

Full Text Available David R Lionberger1, Michael J Brennan21Southwest Orthopedic Group, Houston, TX, USA; 2Department of Medicine, Bridgeport Hospital, Bridgeport, CT, USAAbstract: The objective of this article is to review published clinical data on diclofenac epolamine topical patch 1.3% (DETP in the treatment of acute soft tissue injuries, such as strains, sprains, and contusions. Review of published literature on topical nonsteroidal anti-inflammatory drugs (NSAIDs, diclofenac, and DETP in patients with acute soft tissue injuries was included. Relevant literature was identified on MEDLINE using the search terms topical NSAIDs, diclofenac, diclofenac epolamine, acute pain, sports injury, soft tissue injury, strain, sprain, and contusion, and from citations in retrieved articles covering the years 1978–2008. Review of published, randomized clinical trials and meta-analyses shows that topical NSAIDs are significantly more effective than placebo in relieving acute pain; the pooled average relative benefit was 1.7 (95% confidence interval, 1.5–1.9. In a limited number of comparisons, topical and oral NSAIDs provided comparable pain relief, but the use of topical agents produced lower plasma drug concentrations and fewer systemic adverse events (AEs. The physical–chemical properties of diclofenac epolamine make it well suited for topical use. In patients with acute soft tissue injuries treated with DETP, clinical data report an analgesic benefit within hours of the first application, and significant pain relief relative to placebo within 3 days. Moreover, DETP displayed tolerability comparable with placebo; the most common AEs were pruritus and other application site reactions. Review of published literature suggests that DETP is generally safe and well tolerated, clinically efficacious, and a rational treatment option for patients experiencing acute pain associated with strains, sprains, and contusions, and other localized painful conditions

Fenbendazole improves pathological and functional recovery following traumatic spinal cord injury.

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Yu, C G; Singh, R; Crowdus, C; Raza, K; Kincer, J; Geddes, J W

2014-01-03

During a study of spinal cord injury (SCI), mice in our colony were treated with the anthelmintic fenbendazole to treat pinworms detected in other mice not involved in the study. As this was not part of the original experimental design, we subsequently compared pathological and functional outcomes of SCI in female C57BL/6 mice who received fenbendazole (150 ppm, 8 mg/kg body weight/day) for 4 weeks prior to moderate contusive SCI (50 kdyn force) as compared to mice on the same diet without added fenbendazole. The fenbendazole-treated mice exhibited improved locomotor function, determined using the Basso mouse scale, as well as improved tissue sparing following contusive SCI. Fenbendazole may exert protective effects through multiple possible mechanisms, one of which is inhibition of the proliferation of B lymphocytes, thereby reducing antibody responses. Autoantibodies produced following SCI contribute to the axon damage and locomotor deficits. Fenbendazole pretreatment reduced the injury-induced CD45R-positive B cell signal intensity and IgG immunoreactivity at the lesion epicenter 6 weeks after contusive SCI in mice, consistent with a possible effect on the immune response to the injury. Fenbendazole and related benzimadole antihelmintics are FDA approved, exhibit minimal toxicity, and represent a novel group of potential therapeutics targeting secondary mechanisms following SCI. Copyright © 2013. Published by Elsevier Ltd.

Injuries Sustained in Noncombat Motor Vehicle Accidents During Operation Iraqi Freedom

Science.gov (United States)

2012-01-01

pneumothorax , lung contusion, flail chest ). This finding, and whether it relates in any way to vehicle type, protective equipment worn, or MVA... Trauma Registry. The EMED is a deployment health database maintained by Naval Health Research Center (NHRC), in San Diego, California, and contains...accounted for a majority of all serious injuries. Upon further examination of the 22 serious torso injuries, approximately 40% were chest injuries (e.g

Gastrointestinal injuries from blunt abdominal trauma in children.

Science.gov (United States)

Ameh, E A; Nmadu, P T

2004-04-01

To determine the pattern, presentation and outcome of gastrointestinal injuries from blunt abdominal trauma in children. A retrospective study. Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Twenty one children managed for gastrointestinal injuries from blunt trauma from 1984-2002. The pattern, presentation, management and outcome of gastrointestinal injuries from blunt trauma. In the 19 year period, 1984-2002, 92 children were treated for blunt abdominal trauma, 21(23%) of who had injuries to the gastrointestinal tract. Three presenting after 24 hours had evidence of peritonitis. In six children with isolated gastrointestinal tract (GIT) injury who presented within two hours, abdominal signs were vague at initial evaluation but became marked over a few hours at repeated examination. In eight with associated intraabdominal injuries, abdominal signs were marked at initial examination and five presented with shock. Free peritoneal air was present on plain abdominal and chest radiograph in three of ten patients, dilated bowel loops in six and fluid levels in one. Diagnostic peritoneal lavage or paracentesis was positive in four patients with isolated GIT injuries and eight with associated intraabdominal injuries. There were 24 injuries in the 21 patients consisting of 15 perforations, five contusions, two seromuscular tears, and two gangrene from mesenteric injury. The small intestine was involved in 11 patients, colon six, stomach five, duodenum one and rectum one. Seven (35%) patients had associated extraabdominal injuries. Treatment consisted of simple closure of perforations, over sewing of contusions, resection and anastomosis for gangrene and repair with protective stoma for the rectal injury. One patient each developed prolonged ileus, urinary tract infection and chest infection, respectively postoperatively. Mortality was 28%, all of who had associated intraabdominal or extraabdominal injuries. Gastrointestinal injury from blunt abdominal trauma in

Alteration and reorganization of functional networks: a new perspective in brain injury study

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Nazareth P. Castellanos

2011-09-01

Full Text Available Plasticity is the mechanism underlying brain’s potential capability to compensate injury. Recently several studies have shown that functional connections among brain areas are severely altered by brain injury and plasticity leading to a reorganization of the networks. This new approach studies the impact of brain injury by means of alteration of functional interactions. The concept of functional connectivity refers to the statistical interdependencies between physiological time series simultaneously recorded in various brain areas and it could be an essential tool for brain function studies, being its deviation from healthy reference an indicator for damage. In this article, we review studies investigating functional connectivity changes after brain injury and subsequent recovery, providing an accessible introduction to common mathematical methods to infer functional connectivity, exploring their capabilities, future perspectives and clinical uses in brain injury studies.

PREVALENCE AND TYPES OF SPORTS INJURIES PRESENTING TO EMERGENCY DEPARTMENT SUEZ CANAL UNIVERSITY HOSPITAL

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Adel Hamed Elbaih

2016-10-01

Full Text Available Inroduction: regular physical activity is essential for the prevention of various diseases and reduces the risk of premature mortality in general and coronary heart disease, hypertension, colon cancer, obesity and diabetes mellitus in particular. Aim of this study was to assess the most common sports causing injuries and to assess the types and mechanisms of these injuries. Patients and methods: The researcher examined 250 patients attending emergency departmentl. Results: The study showed that the most common type of sports involved in injury was football .The ankle was the most common affected part in the whole body . Chest contusion and back contusion were the most common types of sports injuries in head, neck and trunk. Fracture scaphoid and fissure radius were the most common sport injuries. Ankle sprain was the most common injury. The study showed that (62.7% of the studied patients who were playing football had injuries in the lower limbs. Ankle sprain was the most common sport injury that was associated with wearing football shoes . Conclusion: Ankle sprain was the most common sport injury associated with artificial grass court . Wrist sprain was the common sport injury in the upper limbs associated with artificial grass court .

Persistent injury-associated anemia: the role of the bone marrow microenvironment.

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Millar, Jessica K; Kannan, Kolenkode B; Loftus, Tyler J; Alamo, Ines G; Plazas, Jessica; Efron, Philip A; Mohr, Alicia M

2017-06-15

The regulation of erythropoiesis involves hematopoietic progenitor cells, bone marrow stroma, and the microenvironment. Following severe injury, a hypercatecholamine state develops that is associated with increased mobilization of hematopoietic progenitor cells to peripheral blood and decreased growth of bone marrow erythroid progenitor cells that manifests clinically as a persistent injury-associated anemia. Changes within the bone marrow microenvironment influence the development of erythroid progenitor cells. Therefore, we sought to determine the effects of lung contusion, hemorrhagic shock, and chronic stress on the hematopoietic cytokine response. Bone marrow was obtained from male Sprague-Dawley rats (n = 6/group) killed 7 d after lung contusion followed by hemorrhagic shock (LCHS) or LCHS followed by daily chronic restraint stress (LCHS/CS). End point polymerase chain reaction was performed for interleukin-1β, interleukin-10, stem cell factor, transforming growth factor-β, high-mobility group box-1 (HMGB-1), and B-cell lymphoma-extra large. Seven days following LCHS and LCHS/CS, bone marrow expression of prohematopoietic cytokines (interleukin-1β, interleukin-10, stem cell factor, and transforming growth factor-β) was significantly decreased, and bone marrow expression of HMGB-1 was significantly increased. B-cell lymphoma-extra large bone marrow expression was not affected by LCHS or LCHS/CS (naïve: 44 ± 12, LCHS: 44 ± 12, LCHS/CS: 37 ± 1, all P > 0.05). The bone marrow microenvironment was significantly altered following severe trauma in a rodent model. Prohematopoietic cytokines were downregulated, and the proinflammatory cytokine HMGB-1 had increased bone marrow expression. Modulation of the bone marrow microenvironment may represent a therapeutic strategy following severe trauma to alleviate persistent injury-associated anemia. Copyright © 2017 Elsevier Inc. All rights reserved.

Study of Alterations in Lipid Profile After Burn Injury.

Directory of Open Access Journals (Sweden)

Dr.Asha Khubchandani

2017-06-01

Full Text Available Introduction: After burn injury, changes in lipid profile occur in body. Dyslipidemia after burn injury is one of the important alterations. Objective: To check alterations in lipid profile after burn injury. Materials and Method: It was cross sectional study which was carried out on 250 burns patients of both sex, with an age group of 18-45 years, and varying burns percentage of 20-80% of total body surface area (TBSA. Serum cholesterol, serum LDL, serum HDL and serum triglyceride level were measured on XL-640 fully-auto biochemical analyser. Serum LDL and HDL were measured by Accelerator Selective Detergent Method. Serum cholesterol and triglyceride were measured by Trindor’s method. Results: Results showed decrease in serum cholesterol, serum LDL and serum HDL, while increase in serum triglyceride level in burns patients compared to normal subjects. Conclusion: This study clearly showed the importance of measuring serum cholesterol, TG, LDL and HDL in burn patients and targeting changes that occur in their levels along the burns course, which may have beneficial effect in protection from organ damage, increasing survival rates and improving burn outcome.

Neck injuries presenting to emergency departments in the United States from 1990 to 1999 for ice hockey, soccer, and American football.

Science.gov (United States)

Delaney, J S; Al-Kashmiri, A

2005-04-01

To examine the number and rate of neck injuries in the community as a whole for ice hockey, soccer, and American football by analysing data from patients presenting to emergency departments in the United States from 1990 to 1999. Data compiled for the US Consumer Product Safety Commission were used to generate estimates for the total number of neck injuries and the more specific diagnoses of neck fractures, dislocations, contusions, sprains, strains, and lacerations occurring nationally from 1990 to 1999. These data were combined with yearly participation figures to generate rates of injury presenting to emergency departments for each sport. There were an estimated 5038 neck injuries from ice hockey, 19,341 from soccer, and 114 706 from American football. These could be broken down as follows: 4964 contusions, sprains, or strains from ice hockey, 17,927 from soccer, and 104 483 from football; 105 neck fractures or dislocations from ice hockey, 214 from soccer, and 1588 from football; 199 neck lacerations for ice hockey, 0 for soccer, and 621 for football. The rates for total neck injuries and combined neck contusions, sprains, or strains were higher for football than for ice hockey or soccer in all years for which data were available. The rate of neck injury in the United States was higher in football than in ice hockey or soccer in the time period studied.

Gastrointestinal injuries from blunt abdominal trauma in children ...

African Journals Online (AJOL)

Treatment consisted of simple closure of perforations, over sewing of contusions, resection and anastomosis for gangrene and repair with protective stoma for the rectal injury. One patient each developed prolonged ileus, urinary tract infection and chest infection, respectively postoperatively. Mortality was 28%, all of who ...

Pathological Fingerprints, Systems Biology and Biomarkers of Blast Brain Injury

Science.gov (United States)

2010-06-01

changes after blast injury. J. Trauma 56, 393–403. Murthy, J.M., Chopra, J.S., and Gulati, D.R. (1979). Subdural hematoma in an adult following a blast...neuronal damage), diffuse brain injury, and subdural hemorrhage. It is still controversial whether primary blast forces directly damage the brain, and if...emboli, leading to infarction (Guy et al., 2000a; Guy et al., 2000b). The most common types of TBI are diffuse axonal injury, contusion, and subdural

MR imaging of central nervous system birth injuries

International Nuclear Information System (INIS)

Heier, L.A.; Zimmerman, R.D.

1991-01-01

This paper reports on head injuries due to birth trauma that have been evaluated with plain radiography, US, and CT. In the past, patient monitoring and transportation difficulties for a neonate have limited the use of MR. Does MR provide more information that would assist the management and prognostic assessment of these patients? An MR examination was requested on all neonates born or transferred to our institution with a documented traumatic delivery. CT and MR studies were compared for seven patients, including three cases of difficult forceps delivery, one case of double footling breech with forceps head extraction, two cases of shoulder dystocias, and one case of vacuum extraction. CT caused underestimation of subdural hematomas and contusions in three of five patients with this injury. The appreciation of a large subdural hematoma at MR resulted in surgical intervention. Both unsuspected cervical cord contusion and complete cord transection were identified on sagittal head MR images. Four of four skull fractures identified at CT were not seen at MR

Bone contusions in the adolescent knee: confusion with rupture of anterior cruciate ligament

International Nuclear Information System (INIS)

Roca, M.; Mota, J.; Guedea, A.

1998-01-01

One of the most specific secondary findings, on magnetic resonance imaging, associated with acute rupture of anterior cruciate ligament (ACL) are bone contusions of lateral femoral condyle or tibial plateau.Given the marked specificity of these indirect findings (97% to 100%), their presence corroborates the diagnosis of ACL tears. The unreliability of these signs in adolescents has recently been reported. We present a case of subchondral bone contusion with intact ACL, the knowledge of which may prevent potential misinterpretations and unnecessary arthroscopic examinations. (Author) 9 refs

The diagnosis and management of children with blunt injury of the chest.

Science.gov (United States)

Sartorelli, Kennith H; Vane, Dennis W

2004-05-01

Thoracic trauma remains a major source of morbidity and mortality in injured children, and is second only to brain injuries as a cause of death. The presence of a chest injury increases an injured child's mortality by 20-fold. Greater than 80% of chest injuries in children are secondary to blunt trauma. The compliant chest wall in children makes pulmonary contusions and rib fractures the most common chest injuries in children. Injuries to the great vessels, esophagus, and diaphragm are rare. Failure to promptly diagnose and treat these injuries results in increased morbidity and mortality.

Cranial MR imaging and cerebral 99mTc HM-PAO-SPECT in patients with subacute or chronic severe closed head injury and normal CT examinations

International Nuclear Information System (INIS)

Prayer, L.; Wimberger, D.; Oder, W.; Kramer, J.; Schindler, E.; Podreka, I.; Imhof, H.

1993-01-01

Eighteen patients in the subacute or chronic state following severe closed head injury with normal cranial CT scans were examined by MR and 99m Tc HM-PAO SPECT. Correlations were sought between these 2 imaging modalities and the clinical outcome, as defined by the Glasgow Outcome Scale (GOX) score. Both MR and SPECT revealed cerebral damage in all patients examined but structural and functional alterations did not coincide topographically in 64.9% of lesions. Nevertheless, complementary injury patterns suggesting poor recovery were found; cortical contusions and diffuse axonal injury (MR) in conjunction with cortical and thalamic hypoperfusion (SPECT) were noticed in 8 out of 12 patients with unfavorable outcome (GOS = III and IV). The synthesis of MR and SPECT information clearly enhanced the ability both to accurately assess posttraumatic brain damage and to improve patients' outcome prediction. (au) (18 refs.)

Cranial MR imaging and cerebral 99mTc HM-PAO-SPECT in patients with subacute or chronic severe closed head injury and normal CT examinations

International Nuclear Information System (INIS)

Prayer, L.; Wimberger, D.; Oder, W.; Kramer, J.; Schindler, E.; Podreka, I.; Imhof, H.

1993-01-01

Eighteen patients in the subacute or chronic state following severe closed head injury with normal cranial CT scans were examined by MR and 99m Tc HM-PAO SPECT. Correlations were sought between these 2 imaging modalities and the clinical outcome, as defined by the Glasgow Outcome Scale (GOS) score. Both MR and SPECT revealed cerebral damage in all patients examined but structural and functional alterations did not coincide topographically in 64.9% of lesions. Nevertheless, complementary injury patterns suggesting poor recovery were found; cortical contusions and diffuse axonal injury (MR) in conjunction with cortical and thalamic hypoperfusion (SPECT) were noticed in 8 out of 12 patients with unfavorable outcome (GOS=III and IV). The synthesis of MR and SPECT information clearly enhanced the ability both to accurately assess posttraumatic brain damage and to improve patients' outcome prediction. (orig.)

Cranial MR imaging and cerebral [sup 99m]Tc HM-PAO-SPECT in patients with subacute or chronic severe closed head injury and normal CT examinations

Energy Technology Data Exchange (ETDEWEB)

Prayer, L.; Wimberger, D.; Oder, W.; Kramer, J.; Schindler, E.; Podreka, I.; Imhof, H.

1993-11-01

Eighteen patients in the subacute or chronic state following severe closed head injury with normal cranial CT scans were examined by MR and [sup 99m]Tc HM-PAO SPECT. Correlations were sought between these 2 imaging modalities and the clinical outcome, as defined by the Glasgow Outcome Scale (GOX) score. Both MR and SPECT revealed cerebral damage in all patients examined but structural and functional alterations did not coincide topographically in 64.9% of lesions. Nevertheless, complementary injury patterns suggesting poor recovery were found; cortical contusions and diffuse axonal injury (MR) in conjunction with cortical and thalamic hypoperfusion (SPECT) were noticed in 8 out of 12 patients with unfavorable outcome (GOS = III and IV). The synthesis of MR and SPECT information clearly enhanced the ability both to accurately assess posttraumatic brain damage and to improve patients' outcome prediction. (au) (18 refs.).

Computer tomography of the brain and spectrophotometry of the CSF in cerebral concussion and contusion

International Nuclear Information System (INIS)

Bergvall, U.; Kjellin, K.G.; Levander, B.; Svendsen, P.; Soederstroem, C.E.

1978-01-01

Computer tomography (CT) and spectrophotometry of CSF were performed in 30 patients with the clinical diagnosis of cerebral concussion or contusion. The patients with concussion all had normal CT-findings. Spectrophotometry of CSF was sometimes positive for cerebral contusion with normal CT-findings, but the two methods were complementary so that the extent of the lesion was determined by CT and spectrophotometry of CSF indicated the cause. (Auth.)

Tissue sparing, behavioral recovery, supraspinal axonal sparing/regeneration following sub-acute glial transplantation in a model of spinal cord contusion.

Science.gov (United States)

Barbour, Helen R; Plant, Christine D; Harvey, Alan R; Plant, Giles W

2013-09-27

It has been shown that olfactory ensheathing glia (OEG) and Schwann cell (SCs) transplantation are beneficial as cellular treatments for spinal cord injury (SCI), especially acute and sub-acute time points. In this study, we transplanted DsRED transduced adult OEG and SCs sub-acutely (14 days) following a T10 moderate spinal cord contusion injury in the rat. Behaviour was measured by open field (BBB) and horizontal ladder walking tests to ascertain improvements in locomotor function. Fluorogold staining was injected into the distal spinal cord to determine the extent of supraspinal and propriospinal axonal sparing/regeneration at 4 months post injection time point. The purpose of this study was to investigate if OEG and SCs cells injected sub acutely (14 days after injury) could: (i) improve behavioral outcomes, (ii) induce sparing/regeneration of propriospinal and supraspinal projections, and (iii) reduce tissue loss. OEG and SCs transplanted rats showed significant increased locomotion when compared to control injury only in the open field tests (BBB). However, the ladder walk test did not show statistically significant differences between treatment and control groups. Fluorogold retrograde tracing showed a statistically significant increase in the number of supraspinal nuclei projecting into the distal spinal cord in both OEG and SCs transplanted rats. These included the raphe, reticular and vestibular systems. Further pairwise multiple comparison tests also showed a statistically significant increase in raphe projecting neurons in OEG transplanted rats when compared to SCs transplanted animals. Immunohistochemistry of spinal cord sections short term (2 weeks) and long term (4 months) showed differences in host glial activity, migration and proteoglycan deposits between the two cell types. Histochemical staining revealed that the volume of tissue remaining at the lesion site had increased in all OEG and SCs treated groups. Significant tissue sparing was

[Chest Injury and its Surgical Treatment in Polytrauma Patients. Five-Year Experience].

Science.gov (United States)

Vodička, J; Doležal, J; Vejvodová, Š; Šafránek, J; Špidlen, V; Třeška, V

2016-01-01

PURPOSE OF THE STUDY Thoracic trauma, one of the most frequent injuries in patients with multiple traumata, is found in 50 to 80% of these patients and it is crucial for the patient's prognosis. It accounts for 25% of all death from polytraumatic injuries. The aim of this retrospective study was an analysis of the occurrence of chest injuries in polytrauma patients and their surgical treatment in the Trauma Centre or Department of Surgery of the University Hospital Pilsen in a five-year period. MATERIAL AND METHODS Patients with injuries meeting the definition of polytrauma and an Injury Severity Score (ISS) ≥16 were included. The demographic characteristics, mechanism of multiple trauma, ISS value and chest injury were recorded in each patient. The number of injured patients in each year of the study was noted. In the patients with chest injury, the type of injury and method of treatment were assessed. The therapy was further analysed including its timing. The number of deaths due to polytrauma involving chest injury, the cause of death and its time in relation to the patient's admission to the Trauma Centre were evaluated. RESULTS In the period 2010-14, 513 polytrauma patients were treated; of them 371 (72.3%) were men with an average age of 40.5 years. The most frequent cause of injury was a traffic accident (74%). The average ISS of the whole group was 35 points. Chest injury was diagnosed in 469 patients (91.4%) of whom only five (1.1%) had penetrating injury. Pulmonary contusion was most frequent (314 patients; 67%). A total of 212 patients with chest injury underwent surgery (45.2%); urgent surgery was performed in 143 (67.5%), acute surgery in 49 (23.1%) and delayed surgery in 63 (29.7%) patients. Chest drainage was the major surgical procedure used in the whole group. Of 61 patients who died, 52 had chest injury. In this subgroup the most frequent cause of death was decompensated traumatic shock (26 patients; 50%). In the whole group, 32 polytrauma

Diffusion MRI and the Detection of Alterations Following Traumatic Brain Injury

Science.gov (United States)

2017-06-13

vascular injury, disruption of water home- ostasis), changes in tissue composition (e.g., increased or decreased cellu- larity), and alterations in...related alterations Tissue environment Expected diffusion changes Major citations dMRI evidence Neurons cell loss necrosis and apoptosis atrophy...structure and signaling, vascular coupling, and waste removal, among others. Astrocytes are at least as numerous as neurons in the brain (Herculano-Houzel

Enhanced motor function by training in spinal cord contused rats following radiation therapy.

Directory of Open Access Journals (Sweden)

Ronaldo Ichiyama

Full Text Available Weight-bearing stepping, without supraspinal re-connectivity, can be attained by treadmill training in an animal whose spinal cord has been completely transected at the lower thoracic level. Repair of damaged tissue and of supraspinal connectivity/circuitry following spinal cord injury in rat can be achieved by specific cell elimination with radiation therapy of the lesion site delivered within a critical time window, 2-3 weeks postinjury. Here we examined the effects of training in the repaired spinal cord following clinical radiation therapy. Studies were performed in a severe rat spinal cord contusion injury model, one similar to fracture/crush injuries in humans; the injury was at the lower thoracic level and the training was a combined hindlimb standing and stepping protocol. Radiotherapy, in a similar manner to that reported previously, resulted in a significant level of tissue repair/preservation at the lesion site. Training in the irradiated group, as determined by limb kinematics tests, resulted in functional improvements that were significant for standing and stepping capacity, and yielded a significant direct correlation between standing and stepping performance. In contrast, the training in the unirradiated group resulted in no apparent beneficial effects, and yielded an inverse correlation between standing and stepping performance, e.g., subject with good standing showed poor stepping capacity. Further, without any training, a differential functional change was observed in the irradiated group; standing capacity was significantly inhibited while stepping showed a slight trend of improvement compared with the unirradiated group. These data suggest that following repair by radiation therapy the spinal circuitries which control posture and locomotor were modified, and that the beneficial functional modulation of these circuitries is use dependent. Further, for restoring beneficial motor function following radiotherapy, training seems

Mountain biking injuries in children and adolescents.

Science.gov (United States)

Aleman, Kylee B; Meyers, Michael C

2010-01-01

Over the last decade, the sport of mountain biking has experienced extensive growth in youth participation. Due to the unpredictable nature of outdoor sport, a lack of rider awareness and increased participation, the number of injuries has unnecessarily increased. Many believe that the actual incidence of trauma in this sport is underestimated and is just the 'tip of the iceberg'. The most common mechanism of injury is usually attributed to downhill riding and forward falling. Although rare, this type of fall can result in serious cranial and thoraco-abdominal trauma. Head and neck trauma continue to be documented, often resulting in concussions and the possibility of permanent neurological sequelae. Upper limb injuries range from minor dermal abrasions, contusions and muscular strains to complex particular fracture dislocations. These are caused by attempting to arrest the face with an outstretched hand, leading to additional direct injury. Common overuse injuries include repeated compression from the handlebars and vibration leading to neurovascular complications in the hands. Along with reports of blunt abdominal trauma and lumbar muscle strains, lower extremity injuries may include various hip/pelvic/groin contusions, patellofemoral inflammation, and various muscle strains. The primary causes of mountain biking injuries in children and adolescents include overuse, excessive fatigue, age, level of experience, and inappropriate or improperly adjusted equipment. Additional factors contributing to trauma among this age group involve musculoskeletal immaturity, collisions and falls, excessive speed, environmental conditions, conditioning and fitness status of the rider, nonconservative behavioural patterns, and inadequate medical care. The limited available data restrict the identification and understanding of specific paediatric mountain biking injuries and injury mechanisms. Education about unnecessary risk of injury, use of protective equipment, suitable bikes

Analysis of injuries in long-distance triathletes.

Science.gov (United States)

Egermann, M; Brocai, D; Lill, C A; Schmitt, H

2003-05-01

Triathlon is an individual sport consisting of three disciplines - swimming, cycling and running. Triathlon has changed from a novel appearance to a very popular Olympic sport within the last fifteen years. Nevertheless, there is not sufficient data about injuries in triathlon. The aim of this retrospective survey was to investigate the incidence of injuries according to class of injuries, anatomical sites and disciplines. Relations to age, sex, performance level, training habits and medical care were analysed. Questionnaires were sent to all German speaking participants of the Ironman Europe 2000. With a response rate of 35 %, 656 questionnaires met the inclusion criteria. At least one injury was experienced by 74.8 % (95 %-CI: 71.3-78.1) of all respondents during their active time in triathlon. 51.1 % (95 %-CI: 47.2-55.0) suffered one or more contusion/skin-abrasions, 33.1 % (95 %-CI: 29.5-36.8) muscle-/tendon-injuries, 29.0 % (95 %-CI: 25.5-32.6) ligament-/capsule-injuries and 11.9 % (95 %-CI: 9.5-14.6) fractures. Most of the injuries happened during cycling (54.8 % [95 %-CI: 51.9-57.8]) within training sessions. 18.7 % (95 %-CI: 16.4-21.2) of all injuries occurred while the athletes were competing. Considering the low number of competition hours per year, the incidence of injuries during competition was higher than during training session. Significant relations were found considering the age, performance level and weekly training hours of the triathletes. Older athletes sustained more fractures (p = 0.024), high performance athletes suffered more contusions/abrasions (p = 0.003) and muscle-tendon-injuries (p = 0.001) and athletes with a large number of weekly training hours suffered more muscle-tendon-injuries (p = 0.014). To summarize, injuries in triathlon seem to be related to age, performance level and weekly training hours, but not to sex, presence of training coach and medical care.

Improved irrigation for hyphema in the treatment of severe contusion hyphema in 106 cases

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Qian-Wei Zhu

2013-09-01

Full Text Available AIM: To investigate the effect of improved irrigation for hyphema in the treatment of severe contusion hyphema.METHODS: Totally 106 patients with severe contusion hyphema underwent viscoelastican and irrigation for hyphema through tunnel incision with urokinas. RESULTS: The hyphema was clear in all patients but 2 cases were rebleeding. The surgery method was superior to the conventional operation in the aspects of vision, intra-ocular pressure and complication.CONCLUSION:Improved irrigation for hyphema could be extended, the operating methods is simple, safe and effective.

Spinal cord injury triggers an intrinsic growth-promoting state in nociceptors.

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Bedi, Supinder S; Lago, Michael T; Masha, Luke I; Crook, Robyn J; Grill, Raymond J; Walters, Edgar T

2012-03-20

Although most investigations of the mechanisms underlying chronic pain after spinal cord injury (SCI) have examined the central nervous system (CNS), recent studies have shown that nociceptive primary afferent neurons display persistent hyperexcitability and spontaneous activity in their peripheral branches and somata in dorsal root ganglia (DRG) after SCI. This suggests that SCI-induced alterations of primary nociceptors contribute to central sensitization and chronic pain after SCI. Does SCI also promote growth of these neurons' fibers, as has been suggested in some reports? The present study tests the hypothesis that SCI induces an intrinsic growth-promoting state in DRG neurons. This was tested by dissociating DRG neurons 3 days or 1 month after spinal contusion injury at thoracic level T10 and measuring neuritic growth 1 day later. Neurons cultured 3 days after SCI exhibited longer neurites without increases in branching ("elongating growth"), compared to neurons from sham-treated or untreated (naïve) rats. Robust promotion of elongating growth was found in small and medium-sized neurons (but not large neurons) from lumbar (L3-L5) and thoracic ganglia immediately above (T9) and below (T10-T11) the contusion site, but not from cervical DRG. Elongating growth was also found in neurons immunoreactive to calcitonin gene-related peptide (CGRP), suggesting that some of the neurons exhibiting enhanced neuritic growth were nociceptors. The same measurements made on neurons dissociated 1 month after SCI revealed no evidence of elongating growth, although evidence for accelerated initiation of neurite outgrowth was found. Under certain conditions this transient growth-promoting state in nociceptors might be important for the development of chronic pain and hyperreflexia after SCI.

Disability pensions in relation to traumatic brain injury: a population study

DEFF Research Database (Denmark)

Teasdale, T W; Engberg, A W

2000-01-01

From a Danish national register of hospitalizations, all patients were identified who had a discharge diagnosis of traumatic brain injury between the years 1979-1993 inclusive, at ages 18-66 years inclusive. These were classified as having suffered either a concussion (n = 74,398), a cranial...... fracture (n = 4,452) or a cerebral contusion (n = 8,141). Patients in each of these groups were then checked in annual registers of disability pension awards between 1979-1995. Disability pensions had been awarded to 16% of the concussion group, 18% of the fracture group, and 33% of the contusion group....... Date of application, grounds for the application, and the pension level awarded were noted. Analysis of the date of application for the disability pension revealed that in all groups a high proportion of the pension applications had been made prior to the injury. Among the concussion group, the pension...

Video incident analysis of head injuries in high school girls' lacrosse.

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Caswell, Shane V; Lincoln, Andrew E; Almquist, Jon L; Dunn, Reginald E; Hinton, Richard Y

2012-04-01

Knowledge of injury mechanisms and game situations associated with head injuries in girls' high school lacrosse is necessary to target prevention efforts. To use video analysis and injury data to provide an objective and comprehensive visual record to identify mechanisms of injury, game characteristics, and penalties associated with head injury in girls' high school lacrosse. Descriptive epidemiology study. In the 25 public high schools of 1 school system, 529 varsity and junior varsity girls' lacrosse games were videotaped by trained videographers during the 2008 and 2009 seasons. Video of head injury incidents was examined to identify associated mechanisms and game characteristics using a lacrosse-specific coding instrument. Of the 25 head injuries (21 concussions and 4 contusions) recorded as game-related incidents by athletic trainers during the 2 seasons, 20 head injuries were captured on video, and 14 incidents had sufficient image quality for analysis. All 14 incidents of head injury (11 concussions, 3 contusions) involved varsity-level athletes. Most head injuries resulted from stick-to-head contact (n = 8), followed by body-to-head contact (n = 4). The most frequent player activities were defending a shot (n = 4) and competing for a loose ball (n = 4). Ten of the 14 head injuries occurred inside the 12-m arc and in front of the goal, and no penalty was called in 12 injury incidents. All injuries involved 2 players, and most resulted from unintentional actions. Turf versus grass did not appear to influence number of head injuries. Comprehensive video analysis suggests that play near the goal at the varsity high school level is associated with head injuries. Absence of penalty calls on most of these plays suggests an area for exploration, such as the extent to which current rules are enforced and the effectiveness of existing rules for the prevention of head injury.

Effect of brain-derived neurotrophic factor on the formation of psycho-vegetative syndrome with brain injury

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Selyanina N.V.

2016-09-01

Full Text Available Aim: to determine the role of brain-derived neurotrophic factor in the formation and forecasting of psycho-vegetative syndrome in patients with cerebral mild to moderate injury. Material and Methods. There have been 150 patients with contusion of the brain, examined. Indicators of neurological, psycho-vegetative status, quantitative content of brain-derived neurotrophic factor (BDNF and nerve growth factor (NGF in the serum were studied. Results. At patients with brain contusion neurological, psycho-vegetative disturbances and decrease neurotrophic factors are determined. It was found to depend of the content of BDNF and psycho-vegetative indicators. Conclusion. The level of brain-derived neurotrophic factor serum (less than 300 pg/ml is a predictor of psycho-vegetative syndrome in the long term of the brain injury.

Head and neck injuries from the Boston Marathon bombing at four hospitals.

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Singh, Ajay K; Buch, Karen; Sung, Edward; Abujudeh, Hani; Sakai, Osamu; Aaron, Sodickson; Lev, Michael

2015-10-01

The aim of this study was to evaluate the imaging findings of head and neck injuries in patients from the Boston Marathon bombing. A total of 115 patients from the Boston Marathon bombing presenting to four hospitals who underwent imaging to evaluate for head and neck injuries were included in the study. Twelve patients with positive findings on radiography or cross-sectional imaging were included in the final analysis. The radiographic, computed tomography (CT), and magnetic resonance (MR) imaging features of these patients were evaluated for the presence of shrapnel and morphological abnormality. Head and neck injuries were seen in 12 out of 115 patients presenting to the four hospitals. There were secondary blast injuries to the head and neck in eight patients, indicated by the presence of shrapnel on imaging. In the four patients without shrapnel, there were two with subgaleal hematomas, one with facial contusion and one with mastoid injury. There were two patients with subarachnoid hemorrhage, one with brain contusion, one with cerebral laceration, and one with globe rupture. There was frontal bone, nasal bone, and orbital wall fracture in one patient each. Imaging identified 26 shrapnel fragments, 21 of which were ball bearings. Injuries to the head and neck region identified on imaging from the Boston Marathon bombing were not common. The injuries seen were predominantly secondary blast injuries from shrapnel, and did not result in calvarial penetration of the shrapnel fragments.

Injury patterns in nordic ski jumpers. A retrospective analysis of injuries occurring at the Intervale Ski Jump Complex from 1980 to 1985.

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Wright, J R; Hixson, E G; Rand, J J

1986-01-01

No studies describing the types and frequencies of nordic ski jumping injuries have been reported in the medical literature. We examined records of injuries sustained at the Intervale Ski Jump Complex (15, 40, 70, and 90 meter jumps) in Lake Placid from 1980 to 1985. Forty-seven injured jumpers sustained 72 total injuries. The most frequent injuries were contusions. Fractures occurred in 11 jumpers; most were nondisplaced. Upper extremity fractures outnumbered lower extremity fractures. Injuries requiring hospitalization were uncommon; none of these resulted in permanent disability. Injury rates for non-World Cup and for World Cup competitions were 4.3 and 1.2 injuries per 1,000 skier-days, respectively. This is roughly equivalent to injury rates in alpine skiing. Our study suggests that the dangers of nordic ski jumping have been overestimated.

Diagnosis of traumatic cardiac contusion

International Nuclear Information System (INIS)

Waxman, K.; Soliman, M.H.; Braunstein, P.; Formosa, P.; Cohen, A.J.; Matsuura, P.; Mason, G.R.

1986-01-01

Cardiac contusion following blunt chest trauma remains a diagnostic problem because of a lack of sensitive diagnostic tests. This study evaluated thallous chloride Tl 201 single-photon-emission computed tomography in a series of 48 patients following blunt chest trauma. Of the 48 patients, 23 had normal scans. None of these patients proved to have serious arrhythmias during three days of continuous monitoring. Of 25 patients with abnormal or ambiguous studies, five (20%) developed serious arrhythmias requiring therapy. Single-photon-emission computed tomography scanning thus was sensitive in indicating that group of patients at risk of serious arrhythmias, and may therefore prove to be a useful screening test to determine the need for hospitalization and arrhythmia monitoring following blunt chest trauma

[Correlation analysis of bone marrow edema degree and serum inflammatory factors change with knee joint pain symptoms in patients with bone contusion around the knee joint].

Science.gov (United States)

Li, Songiun; An, Rongze; Wang, Zhaojie; Kuang, Lipeng; Tan, Weiyuan; Fang, Cunxun

2014-05-01

To explore the correlation between the degree of bone marrow edema (BME) and the content change of tumor necrosis factor alpha (TNF-alpha) and matrix metalloproteinase 3 (MMP-3) and the knee pain symptoms in patients with bone contusion around the knee joint. Thirty patients (30 knees) of bone contusion around the knee joint were chosen as the trial group between October 2009 and April 2012. According to visual analogue scale (VAS), 30 patients were divided into mild group (10 cases), moderate group (10 cases), and severe group (10 cases); according to MRI morphological changes, the patients were divided into type I group (12 cases), type II group (11 cases), and type III group (7 cases). Ten patients (10 knees) with soft tissue injury of the knee were chosen as control group. No significant difference was found (P > 0.05) in gender, age, causes, side, and admission time after injury between 2 groups. The serum contents of MMP-3 and TNF-alpha were detected and statistically analysed between different degrees of pain groups and between different degrees of BME groups. Correlation was analysed between BME and inflammatory factor changes and VAS score. The MMP-3 and TNF-alpha contents in trial group [(29.580 +/- 6.870) (microg/L and (23.750 +/- 7.096) ng/L] were significantly higher than those in control group [(8.219 +/- 1.355) microg/L and (6.485 +/- 1.168) ng/L] (t = 9.686, P = 0.000; t = 7.596, P =0.000). The MMP-3 and TNF-alpha contents in patients with different degrees of pain and BME were significantly higher than those in patients of control group (P pain (P 0.05). Multiple linear regression analysis showed that TNF-alpha content was significantly correlated with VAS score (P = 0.000). Knee pain symptoms are not related to the degree of BME in patients with bone contusion around the knee joint. Inflammatory factor TNF-alpha content is the main influence factor of knee joint pain symptoms.

EYE TRAUMA. OPEN GLOBE INJURY MANAGEMENT

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Mojca Globočnik Petrovič

2004-05-01

Full Text Available Background. Ocular trauma is important cause of blindness. Birmingham Eye Trauma Terminology allows us to use a standardized eye injury terminology which permits an unambigous interpretation. The Eye Injury Registry enables the analysis of medical, epidemyologic and social data.The most frequent ocular injury ocular contusion has a relatively good prognosis. An adequate primary ocular repair and correct timing of pars plana vitrectomy are very important in open globe injury management. There still exist some controversial issues concerning the role of posterior segment surgery in open globe injuries. These include timing of surgery, prophylactic scleral buckle placement and a proper use of systemic and intravitreal antibiotics.Conclusions. With adequate primary ocular repair, the use of systemic, intravitreal antibiotics, scleral buckling and proper timing for pars plana vitrectomy the prognosis for ocular trauma cases can be better.

Topical nonsteroidal anti-inflammatory drugs for the treatment of pain due to soft tissue injury: diclofenac epolamine topical patch.

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Lionberger, David R; Brennan, Michael J

2010-11-10

The objective of this article is to review published clinical data on diclofenac epolamine topical patch 1.3% (DETP) in the treatment of acute soft tissue injuries, such as strains, sprains, and contusions. Review of published literature on topical nonsteroidal anti-inflammatory drugs (NSAIDs), diclofenac, and DETP in patients with acute soft tissue injuries was included. Relevant literature was identified on MEDLINE using the search terms topical NSAIDs, diclofenac, diclofenac epolamine, acute pain, sports injury, soft tissue injury, strain, sprain, and contusion, and from citations in retrieved articles covering the years 1978-2008. Review of published, randomized clinical trials and meta-analyses shows that topical NSAIDs are significantly more effective than placebo in relieving acute pain; the pooled average relative benefit was 1.7 (95% confidence interval, 1.5-1.9). In a limited number of comparisons, topical and oral NSAIDs provided comparable pain relief, but the use of topical agents produced lower plasma drug concentrations and fewer systemic adverse events (AEs). The physical-chemical properties of diclofenac epolamine make it well suited for topical use. In patients with acute soft tissue injuries treated with DETP, clinical data report an analgesic benefit within hours of the first application, and significant pain relief relative to placebo within 3 days. Moreover, DETP displayed tolerability comparable with placebo; the most common AEs were pruritus and other application site reactions. Review of published literature suggests that DETP is generally safe and well tolerated, clinically efficacious, and a rational treatment option for patients experiencing acute pain associated with strains, sprains, and contusions, and other localized painful conditions.

Magnetic resonance imaging in diffuse brain injury

International Nuclear Information System (INIS)

Yokota, Hiroyuki; Yasuda, Kazuhiro; Mashiko, Kunihiro; Henmi, Hiroshi; Otsuka, Toshibumi; Kobayashi, Shiro; Nakazawa, Shozo

1992-01-01

Forty cases diagnosed as diffuse brain injury (DBI) were studied by magnetic resonance imaging (MRI) performed within 3 days after injury. These cases were divided into two groups, which were the concussion group and diffuse axonal injury (DAI) group established by Gennarelli. There were no findings on computerized tomography (CT) in the concussion group except for two cases which had a brain edema or subarachnoid hemorrhage. But on MRI, high intensity areas on T2 weighted imaging were demonstrated in the cerebral white matter in this group. Many lesions in this group were thought to be edemas of the cerebral white matter, because of the fact that on serial MRI, they were isointense. In mild types of DAI, the lesions on MRI were located only in the cerebral white matter, whereas, in the severe types of DAI, lesions were located in the basal ganglia, the corpus callosum, the dorsal part of the brain stem as well as in the cerebral white matter. As for CT findings, parenchymal lesions were not visualized especially in mild DAI. Our results suggested that the lesions in cerebral concussion were edemas in cerebral white matter. In mild DAI they were non-hemorrhagic contusion; and in severe DAI they were hemorrhagic contusions in the cerebral white matter, the basal ganglia, the corpus callosum or the dorsal part of the brain stem. (author)

Mountain biking injuries: an update.

Science.gov (United States)

Kronisch, Robert L; Pfeiffer, Ronald P

2002-01-01

This article reviews the available literature regarding injuries in off-road bicyclists. Recent progress in injury research has allowed the description of several patterns of injury in this sport. Mountain biking remains popular, particularly among young males, although sales and participation figures have decreased in the last several years. Competition in downhill racing has increased, while cross-country racing has decreased somewhat in popularity. Recreational riders comprise the largest segment of participants, but little is known about the demographics and injury epidemiology of noncompetitive mountain cyclists. Most mountain bikers participating in surveys reported a history of previous injuries, but prospective studies conducted at mountain bike races have found injury rates of bike racing the risk of injury may be higher for women than men. Minor injuries such as abrasions and contusions occur frequently, but are usually of little consequence. Fractures usually involve the torso or upper extremities, and shoulder injuries are common. Head and face injuries are not always prevented by current helmet designs. Fatal injuries are rare but have been reported. Improvements in safety equipment, rider training and racecourse design are suggested injury prevention measures. The authors encourage continued research in this sport.

[Perforation of hollow organs in the abdominal contusion: diagnostic features and prognostic factors of death].

Science.gov (United States)

Nicolau, A E; Merlan, V; Dinescu, G; Crăciun, M; Kitkani, A; Beuran, M

2012-01-01

Blunt hollow viscus perforations (HVP) due to abdominal contusions (AC), although rare, are difficult to diagnose early and are associated with a high mortality. Our paper analyses retrospectively data from patients operated for HVP between January 2005 and January 2009, the efficiency of different diagnostic tools, mortality and prognostic factors for death. There were 62 patients operated for HVP, 14 of which had isolated abdominal contusion and 48 were poly trauma patients. There were 9 women and 53 men, the mean age was 41.5 years (SD: +17,9), the mean ISS was 32.94 (SD: +15,94), 23 patients had associated solid viscus injuries (SVI). Clinical examination was irelevant for 16 of the 62 patients, abdominal Xray was false negative for 30 out of 35 patients and abdominal ultrasound was false negative for 16 out of 60 patients. Abdominal CT was initially false negative for 7 out of 38 patients: for 4 of them the abdominal CT was repeated and was positive for HVP, for 3 patients a diagnostic laparoscopy was performed. Direct signs for HVP on abdominal CT were present for 3 out of 38 patients. Diagnostic laparoscopy was performed for 7 patients with suspicion for HVP, and was positive for 6 of them and false negative for a patient with a duodenal perforation. Single organ perforations were present in 55 cases, multi organ perforations were present in 7 cases. There were 15 deaths (15.2%), most of them caused by haemodynamic instability (3 out of 6 patients) and associated lesions: SOL for 9 out of 23 cases, pelvic fracture (PF) for 6 out of 14 patients, craniocerebral trauma (CCT) for 12 out of 33 patients.Multivariate analysis showed that the prognostic factors for death were ISS value (p = 0,023) and associated CCT (odds ratio = 4,95; p = 0,017). The following factors were not confirmed as prognostic factors for death: age, haemodynamic instability, associated SVI, thoracic trauma (TT), pelvic fractures (PF), limbs fractures (LF) and admission-operation interval

Traumatic Mitral Valve and Pericardial Injury

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Nissar Shaikh

2013-01-01

Full Text Available Cardiac injury after blunt trauma is common but underreported. Common cardiac trauma after the blunt chest injury (BCI is cardiac contusion; it is very rare to have cardiac valve injury. The mitral valve injury during chest trauma occurs when extreme pressure is applied at early systole during the isovolumic contraction between the closure of the mitral valve and the opening of the aortic valve. Traumatic mitral valve injury can involve valve leaflet, chordae tendineae, or papillary muscles. For the diagnosis of mitral valve injury, a high index of suspicion is required, as in polytrauma patients, other obvious severe injuries will divert the attention of the treating physician. Clinical picture of patients with mitral valve injury may vary from none to cardiogenic shock. The echocardiogram is the main diagnostic modality of mitral valve injuries. Patient’s clinical condition will dictate the timing and type of surgery or medical therapy. We report a case of mitral valve and pericardial injury in a polytrauma patient, successfully treated in our intensive care unit.

Schwann cell transplantation improves reticulospinal axon growth and forelimb strength after severe cervical spinal cord contusion.

Science.gov (United States)

Schaal, S M; Kitay, B M; Cho, K S; Lo, T P; Barakat, D J; Marcillo, A E; Sanchez, A R; Andrade, C M; Pearse, D D

2007-01-01

Schwann cell (SC) implantation alone has been shown to promote the growth of propriospinal and sensory axons, but not long-tract descending axons, after thoracic spinal cord injury (SCI). In the current study, we examined if an axotomy close to the cell body of origin (so as to enhance the intrinsic growth response) could permit supraspinal axons to grow onto SC grafts. Adult female Fischer rats received a severe (C5) cervical contusion (1.1 mm displacement, 3 KDyn). At 1 week postinjury, 2 million SCs ex vivo transduced with lentiviral vector encoding enhanced green fluorescent protein (EGFP) were implanted within media into the injury epicenter; injury-only animals served as controls. Animals were tested weekly using the BBB score for 7 weeks postimplantation and received at end point tests for upper body strength: self-supported forelimb hanging, forearm grip force, and the incline plane. Following behavioral assessment, animals were anterogradely traced bilaterally from the reticular formation using BDA-Texas Red. Stereological quantification revealed a twofold increase in the numbers of preserved NeuN+ neurons rostral and caudal to the injury/graft site in SC implanted animals, corroborating previous reports of their neuroprotective efficacy. Examination of labeled reticulospinal axon growth revealed that while rarely an axon was present within the lesion site of injury-only controls, numerous reticulospinal axons had penetrated the SC implant/lesion milieu. This has not been observed following implantation of SCs alone into the injured thoracic spinal cord. Significant behavioral improvements over injury-only controls in upper limb strength, including an enhanced grip strength (a 296% increase) and an increased self-supported forelimb hanging, accompanied SC-mediated neuroprotection and reticulospinal axon growth. The current study further supports the neuroprotective efficacy of SC implants after SCI and demonstrates that SCs alone are capable of supporting

Injury Profile in Women Shotokan Karate Championships in Iran (2004-2005)

Science.gov (United States)

Halabchi, Farzin; Ziaee, Vahid; Lotfian, Sarah

2007-01-01

The aims of this paper were to record injury rates among Iranian women competitive Shotokan karate athletes and propose possible predisposing factors. A prospective recording of the injuries resulting from all matches in 6 consecutive women national Shotokan Karate Championships in all age groups in Iran (season 2004-2005) was performed. Data recorded included demographic characteristics (Age and Weight), athletic background (rank, years of experience, time spent training and previous injuries), type, location and reason for the injury, and the result of the match. Results indicate 186 recorded injuries from a total of 1139 bouts involving 1019 athletes, therefore there were 0.163 injury per bout [C.I. 95%: 0.142-0.184] and 183 injuries per 1000 athletes [C.I. 95%: 159-205]. Injuries were most commonly located in the head and neck (55.4%) followed by the lower limb (21%), upper limb (12.9%) and trunk (10.8%). Punches (48. 4%) were associated with more injuries than kicks (33.3%). The injuries consisted of muscle strain and contusion (81, 43.6%), hematoma and epistaxis (49, 26.3%), lacerations and abrasions (28, 15. 1%), concussion (13, 7%), tooth avulsion or subluxation (3, 1.6%), joint dislocation (3, 1.6%) and fractures (3, 1.6%). In conclusion, as the majority of injuries are minor, and severe or longstanding injuries are uncommon, it can be argued that shotokan karate is a relatively safe for females, despite its image as a combat sport, where ostensibly the aim appears to injure your opponent. Further research is needed to evaluate the effective strategies to minimize the risk of injuries. Key points 186 injuries were recorded during women competitions. Incidence rates of 0.163 injury per bout and 183 injuries per 1000 athletes were calculated. The injuries were most commonly located in the head and neck. Muscle strain and contusion, hematoma and epistaxis constitute the majority of injuries. PMID:24198704

Computed tomography in acute head injury

Energy Technology Data Exchange (ETDEWEB)

Takeda, T; Inagawa, T; Yamada, T; Sota, K [Shimane Prefectural Central Hospital (Japan)

1981-01-01

After the introduction of CT (GE-CT/T) in January, 1980, we experienced 81 cases of head injury. We diagnosed these cases into normal in 50 cases, epidural hematoma in 8 cases, subdural hematoma in 5 cases, intracerebral hematoma in 3 cases, cerebral contusion or cerebral swelling in 14 cases and combined hematoma in 1 case, based on CT findings. We diagnose normal, when no abnormal finding is present intracranially. Epidural hematoma is visualized as a bicrescent-shaped high density area on CT scan. Subdural hematoma appears as a crescent-shaped high density area on CT finding. Intracranial hematoma is visualized as a high density area in the brain tissue on CT scan. Cerebral contusion presents as salt and pepper appearance on CT scan representing area of high and low density complex. Brain swelling is visualized as disappearance or compression of ventricles, cisterns, sulci and gyri.

Traumatic brain injury in children in Denmark: a national 15-year study

DEFF Research Database (Denmark)

Engberg, A; Teasdale, T W

1998-01-01

Demographic trends are reported concerning three types of traumatic brain injury (concussions, cranial fractures, and intracranial contusions/haemorrhages) among children in Denmark of ages up to and including 14 years, for a fifteen year period from 1979 through 1993. The data were derived from...... a national computer-based hospitalization register and include 49,594 children, of whom 60% were boys and 89% had suffered a concussion. Virtually all injuries were the result of accidents. A major finding was that there has been a general decline in the incidence of traumatic brain injuries, especially...

Magnetic resonance imaging of traumatic cervical injury

International Nuclear Information System (INIS)

Juhng, S. K.; Lee, K. S.; Sohn, K. J.; Choi, S. S.; Won, J. J.

1994-01-01

To evaluate magnetic resonance imaging (MRI) findings of cevical injuries. MRI studies of 34 patients with cervical spinal injuries were analyzed retrospectively. All MRI scans were obtained with an 1.0T superconductive MRI scanner (Siemens Magnetom 42SPE) and their findings were analyzed regarding the spinal cord, bony spine, ligaments, and intervertebral disks. A variety of abnormal findings were detected: 25 cord abnormalities including cord compression (15 cases), cord edema (4 cases), syringomyelia (4 cases), myelomalacia (1 case), and hemorrhagic contusion (1 case), 18 ligamentous injuries, 22 disk herniations (9 post-traumatic, 13 chronic degenerative), 11 spine fractures, and 4 subluxations. MRI is useful in evaluating the spinal cord itself, in depicting ligamentous injuries, in establishing the presence of disc herniation, and in assessing the alignment of cervical spine

Magnetic resonance imaging of traumatic cervical injury

Energy Technology Data Exchange (ETDEWEB)

Juhng, S. K.; Lee, K. S.; Sohn, K. J.; Choi, S. S.; Won, J. J. [Wonkwang University School of Medicine, Iri (Korea, Republic of)

1994-04-15

To evaluate magnetic resonance imaging (MRI) findings of cevical injuries. MRI studies of 34 patients with cervical spinal injuries were analyzed retrospectively. All MRI scans were obtained with an 1.0T superconductive MRI scanner (Siemens Magnetom 42SPE) and their findings were analyzed regarding the spinal cord, bony spine, ligaments, and intervertebral disks. A variety of abnormal findings were detected: 25 cord abnormalities including cord compression (15 cases), cord edema (4 cases), syringomyelia (4 cases), myelomalacia (1 case), and hemorrhagic contusion (1 case), 18 ligamentous injuries, 22 disk herniations (9 post-traumatic, 13 chronic degenerative), 11 spine fractures, and 4 subluxations. MRI is useful in evaluating the spinal cord itself, in depicting ligamentous injuries, in establishing the presence of disc herniation, and in assessing the alignment of cervical spine.

Clinical application of magnetic resonance in acute traumatic brain injury

Energy Technology Data Exchange (ETDEWEB)

Morais, Dionei F.; Gaia, Felipe F.P. [Hospital de Base de Sao Jose do Rio Preto, SP (Brazil). Servico de Neurocirurgia]. E-mail: centro@cerebroecoluna.com.br; Spotti, Antonio R.; Tognola, Waldir A. [Faculdade de Medicina de Sao Jose do Rio Preto (FAMERP), SP (Brazil). Dept. de Ciencias Neurologicas; Andrade, Almir F. [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Dept. de Neurocirurgia da Emergencia

2008-07-01

Purpose: To evaluate the clinical applications of magnetic resonance imaging (MRI) in patients with acute traumatic brain injury (TBI): to identify the type, quantity, severity; and improvement clinical-radiological correlation. Method: Assessment of 55 patients who were imaged using CT and MRI, 34 (61.8%) males and 21 (38.2%) females, with acute (0 to 5 days) and closed TBI. Results: Statistical significant differences (McNemar test): occurred fractures were detected by CT in 29.1% and by MRI in 3.6% of the patients; subdural hematoma by CT in 10.9% and MRI in 36.4 %; diffuse axonal injury (DAI) by CT in 1.8% and MRI in 50.9%; cortical contusions by CT in 9.1% and MRI in 41.8%; subarachnoid hemorrhage by CT in 18.2% and MRI in 41.8%. Conclusion: MRI was superior to the CT in the identification of DAI, subarachnoid hemorrhage, cortical contusions, and acute subdural hematoma; however it was inferior in diagnosing fractures. The detection of DAI was associated with the severity of acute TBI. (author)

Clinical application of magnetic resonance in acute traumatic brain injury

International Nuclear Information System (INIS)

Morais, Dionei F.; Gaia, Felipe F.P.; Spotti, Antonio R.; Tognola, Waldir A.; Andrade, Almir F.

2008-01-01

Purpose: To evaluate the clinical applications of magnetic resonance imaging (MRI) in patients with acute traumatic brain injury (TBI): to identify the type, quantity, severity; and improvement clinical-radiological correlation. Method: Assessment of 55 patients who were imaged using CT and MRI, 34 (61.8%) males and 21 (38.2%) females, with acute (0 to 5 days) and closed TBI. Results: Statistical significant differences (McNemar test): occurred fractures were detected by CT in 29.1% and by MRI in 3.6% of the patients; subdural hematoma by CT in 10.9% and MRI in 36.4 %; diffuse axonal injury (DAI) by CT in 1.8% and MRI in 50.9%; cortical contusions by CT in 9.1% and MRI in 41.8%; subarachnoid hemorrhage by CT in 18.2% and MRI in 41.8%. Conclusion: MRI was superior to the CT in the identification of DAI, subarachnoid hemorrhage, cortical contusions, and acute subdural hematoma; however it was inferior in diagnosing fractures. The detection of DAI was associated with the severity of acute TBI. (author)

Unilateral traumatic hemorrhage of the basal ganglion and bihemisferic cerebral infarction

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Moscote-Salazar Luis Rafael

2017-09-01

Full Text Available Among the various injuries caused by the cerebral tramatic lesion are traumatic brain contusions. Hemorrhagic contusions of the basal ganglia are unusual. Different injuries such as cranial fractures, epidural hemorrhage, subdural hematoma, subarachnoid hemorrhage among others may be associated with brain contusions. In some cases traumatic brain injury arises. We present a case of a patient with unilateral cerebral contusion associated with bihemispheric cerebral infarction.

Injuries in youth football: national emergency department visits during 2001-2005 for young and adolescent players.

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Mello, Michael J; Myers, Richard; Christian, Jennifer B; Palmisciano, Lynne; Linakis, James G

2009-03-01

Limited research exists describing youth football injuries, and many of these are confined to specific regions or communities. The authors describe U.S. pediatric football injury patterns receiving emergency department (ED) evaluation and compare injury patterns between the younger and older youth football participants. A retrospective analysis of ED data on football injuries was performed using the National Electronic Injury Surveillance System-All Injury Program. Injury risk estimates were calculated over a 5-year period (2001-2005) using participation data from the National Sporting Goods Association. Injury types are described for young (7-11 years) and adolescent (12-17 years) male football participants. There were an estimated total of 1,060,823 visits to U.S. EDs for males with football-related injuries. The most common diagnoses in the younger group (7-11 years) were fracture/dislocation (29%), sprain/strain (27%), and contusion (27%). In the older group (ages 12-17 years), diagnoses included sprain/strain (31%), fracture/dislocation (29%), and contusion (23%). Older participants had a significantly higher injury risk of injury over the 5-year study period: 11.0 (95% confidence interval [CI] = 9.2 to 12.8) versus 6.1 (95% CI = 4.8 to 7.3) per 1,000 participants/year. Older participants had a higher injury risk across all categories, with the greatest disparity being with traumatic brain injury (TBI), 0.8 (95% CI = 0.6 to 1.0) versus 0.3 (95% CI = 0.2 to 0.4) per 1,000 participants/year. National youth football injury patterns are similar to those previously reported in community and cohort studies. Older participants have a significantly higher injury risk, especially with TBI.

Neural Plasticity and Neurorehabilitation Following Traumatic Brain Injury

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2011-04-01

of Theresa Jones for sectioning and staining . To date, the brains have been sectioned and one set stained for Nissl . Using the Nissl stained ...three rehabilitations decreases contusion size compared to CCI-Yoked (#p=0.051). The remaining sets of brain sections have been stained with...optical densitometry, as appropriate, given staining patterns. Sample locations will be the remaining sensorimotor cortex around the injury, in the

Clobazam-Treated Patients with Lennox Gastaut Syndrome Experienced Fewer Seizure-Related Injuries than Placebo Patients During Trail OV-1012

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2016-08-19

severe seizure- related AEs occurred in the placebo group, with three patients experiencing one severe AE each (fall, contusion, or jaw fracture ). In all...only one non–seizure- related injury, and therefore no evidence to suggest that the drug was associated with injuries. The analysis also helps to...Clobazam-treated patients with Lennox-Gastaut syndrome experienced fewer seizure- related injuries than placebo patients during trial OV-1012 *Jouko

Alteration of renal excretion pathways in gentamicin-induced renal injury in rats.

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Ma, Yan-Rong; Luo, Xuan; Wu, Yan-Fang; Zhang, Tiffany; Zhang, Fan; Zhang, Guo-Qiang; Wu, Xin-An

2018-02-20

The kidney plays a major part in the elimination of many drugs and their metabolites, and drug-induced kidney injury commonly alters either glomerular filtration or tubular transport, or both. However, the renal excretion pathway of drugs has not been fully elucidated at different stages of renal injury. This study aimed to evaluate the alteration of renal excretion pathways in gentamicin (GEN)-induced renal injury in rats. Results showed that serum cystatin C, creatinine and urea nitrogen levels were greatly increased by the exposure of GEN (100 mg kg -1 ), and creatinine concentration was increased by 39.7% by GEN (50 mg kg -1 ). GEN dose-dependently upregulated the protein expression of rOCT1, downregulated rOCT2 and rOAT1, but not affected rOAT2. Efflux transporters, rMRP2, rMRP4 and rBCRP expressions were significantly increased by GEN(100), and the rMATE1 level was markedly increased by GEN(50) but decreased by GEN(100). GEN(50) did not alter the urinary excretion of inulin, but increased metformin and furosemide excretion. However, GEN(100) resulted in a significant decrease of the urinary excretion of inulin, metformin and p-aminohippurate. In addition, urinary metformin excretions in vivo were significantly decreased by GEN(100), but slightly increased by GEN(50). These results suggested that GEN(50) resulted in the induction of rOCTs-rMATE1 and rOAT3-rMRPs pathway, but not changed the glomerular filtration rate, and GEN(100)-induced acute kidney injury caused the downregulated function of glomerular filtration -rOCTs-rMATE1 and -rOAT1-rMRPs pathway. Copyright © 2018 John Wiley & Sons, Ltd.

Delayed presentation of compartment syndrome of the thigh secondary to quadriceps trauma and vascular injury in a soccer athlete

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Moo Ing How

2015-01-01

Conclusion: A high index of suspicion for compartment syndrome is needed in all severe quadriceps contusion. Vascular injury can cause thigh compartment syndrome in sports trauma. MRI findings of deep thigh muscle swelling and “blow-out” tear of the vastus lateralis are strongly suggestive of severe quadriceps injury, and may be a harbinger of delayed thigh compartment syndrome.

Structural and Functional Alterations in Neocortical Circuits after Mild Traumatic Brain Injury

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Vascak, Michal

National concern over traumatic brain injury (TBI) is growing rapidly. Recent focus is on mild TBI (mTBI), which is the most prevalent injury level in both civilian and military demographics. A preeminent sequelae of mTBI is cognitive network disruption. Advanced neuroimaging of mTBI victims supports this premise, revealing alterations in activation and structure-function of excitatory and inhibitory neuronal systems, which are essential for network processing. However, clinical neuroimaging cannot resolve the cellular and molecular substrates underlying such changes. Therefore, to understand the full scope of mTBI-induced alterations it is necessary to study cortical networks on the microscopic level, where neurons form local networks that are the fundamental computational modules supporting cognition. Recently, in a well-controlled animal model of mTBI, we demonstrated in the excitatory pyramidal neuron system, isolated diffuse axonal injury (DAI), in concert with electrophysiological abnormalities in nearby intact (non-DAI) neurons. These findings were consistent with altered axon initial segment (AIS) intrinsic activity functionally associated with structural plasticity, and/or disturbances in extrinsic systems related to parvalbumin (PV)-expressing interneurons that form GABAergic synapses along the pyramidal neuron perisomatic/AIS domains. The AIS and perisomatic GABAergic synapses are domains critical for regulating neuronal activity and E-I balance. In this dissertation, we focus on the neocortical excitatory pyramidal neuron/inhibitory PV+ interneuron local network following mTBI. Our central hypothesis is that mTBI disrupts neuronal network structure and function causing imbalance of excitatory and inhibitory systems. To address this hypothesis we exploited transgenic and cre/lox mouse models of mTBI, employing approaches that couple state-of-the-art bioimaging with electrophysiology to determine the structuralfunctional alterations of excitatory and

Frequency and significance of thoracic injuries detected on abdominal trauma CT scans

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Hareli, G.S.; Rhea, J.T.; Novelline, R.A.; Lawrason, N.; Sacknoff, R.; Oser, A.

1987-01-01

The authors have noted that in multiple trauma patients chest injuries inapparent on initial chest radiographs may be detected at abdominal CT. In an ongoing series of 112 patients to date, 50 chest injuries were detected in 33 patients (29%). The injuries included 15 bilateral hemothoraces, seven unilateral hemothoraces, seven posttraumatic atrelectasis, seven lung contusions, five pneumothoraces, four rib factures, two thoracic spine fractures, two chest wall emphysema, and one mediastinal emphysema. In 24 of the 33 patients (72%) the injury was not seen on the initial chest radiographs; in seven patients treatment of the chest injury was required. The authors have included screening cuts of the middle and upper chest as part of their abdominal CT protocol

Prevalence of injuries in Wushu competition during the 1st Asian Martial Arts Games 2009.

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Yiemsiri, Pichet; Wanawan, Amarin

2014-02-01

To determine the prevalence and characteristic of injuries in Wushu Competition during the IP' Asian MartialArts Games 2009. Sixty international athletes (38 males) participating in Wushu Competition during the 1st Asian Martial Arts Games 2009. Injuries were recorded on injury report forms to document any injuries seen and treatment provided by tournament physician during competitions. The injury forms described the athlete s causes, type, site, and severity of the injuries. There were 60 international athletes the average age were 22.49 +/- 3.75 years. The prevalence ofinjuries was 228.07/ 1000 athlete exposure (AE). The prevalence in males andfemales was 161.76/1000 AE and 326.09/1000 AE, respectively. The most common injured body parts in males were lower extremities 102.94/1000 AE, followed by head and face injuries 58.82/1000 AE. The most common injured body parts in females were lower extremities 282.61/1000 AE. The most common types of injuries in males were contusions 58.82/1000 AE, concussion 29.41/1000 AE and strain-sprain 29.41/1000 AE. In females the most common type of injury were contusion 195.65/1000 AEfollowed by strain-sprain 130.43/1000 AE. The most common mechanism of injury in males werereceiving a punch 58.82/1000 AE, receiving a kick 44.12/1000 AE and delivering a kick 44.12/1000 AE. Meanwhile, in females common mechanisms were receiving a kick 152.17/1000 AE followed by delivering a kick 130.43/1000 AE. High prevalence of injuries in Wushu competition during the 1" Asian MartialArts Games 2009 revealedfemale injuries were higher than male and had a higher prevalence compared with Muay Thai or Taekwondo competitions.

Injury and illness surveillance during the 24th Men's Handball World Championship 2015 in Qatar.

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Bere, Tone; Alonso, Juan-Manuel; Wangensteen, Arnlaug; Bakken, Arnhild; Eirale, Cristiano; Dijkstra, H Paul; Ahmed, Hosny; Bahr, Roald; Popovic, Nebojsa

2015-09-01

The IOC encourages international federations to establish systematic athlete injury and illness surveillance programmes. To describe pattern of injuries and illnesses during the 24th Men's Handball World Championship 2015 by implementing the IOC injury and illness surveillance protocol. The medical staff of participating teams (n=24) were requested to report all new injuries and illnesses during matches and/or training on a daily basis throughout the event (15 January to 1 February, 2015). Exposure (number of player-hours) during all matches was calculated for all players (n=384) and for each of the 4 player positions (wing, back, line and goalkeeper). Medical staff of all teams submitted 96.7% (n=325) of the daily report forms. In total, 27.1% of the players were injured, and of the 132 injuries reported, 40% were time-loss injuries. The total incidence of injuries was 104.5 per 1000 player-hours. The highest risk of injury was found among line players, and more injuries occurred during the first half of the matches. The most frequent injury location was the ankle, followed by the thigh, knee and head/face. The majority of injuries were contusion, sprain or strain. In total, 10.9% of the players were affected by an illness during the event. Of the 42 cases recorded, 31 (73.8%) were reported as respiratory tract infection. The risk of injury in handball is high among Olympic sports. Preventive measures should focus on contusions, ankle sprains, and thigh muscle strains, as well as measures aimed to reduce upper respiratory tract infections. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The prevalence of neurocranium injury in children in Brod-Posavina County.

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Mihić, Josip; Rotim, Kresimir; Marcikić, Marcel; Smiljanić, Danko; Dikanović, Marinko; Jurjević, Matija; Matić, Ivo

2012-12-01

Head injuries are very common in children and are the most frequent cause of disability and death among children. This retrospective study included 350 children hospitalized for injury of neurocranium over a 5-year period at Dr Josip Bencević General Hospital in Slavonski Brod. Boys were more commonly injured (63.4%) than girls. The most common injuries were recorded in children aged 7-14 (47.1%), followed by those aged 1-6 (33.8%) years. The injuries occurred slightly more often in urban (50.9%) than in rural (46.6%) setting. Children were more commonly injured in the street or on the road (38.6%), followed by injuries sustained at home (35.2%), at school (9.3%) and on playgrounds (5.7%). They were most commonly injured by fall (50%), followed by traffic injuries (33.5%). Statistically significant differences were found in the following age groups: all children younger than one year were injured by fall; children aged 1-14 were mostly injured by fall (less in traffic, and due to hitting), and those aged 15-18 mostly in traffic (less by fall and due to hitting). Children were mostly injured in the street or on the road (in traffic accidents), followed by injuries at home (mostly by fall), at school and around the house or in the yard (mostly by fall); on the playground (due to hitting) and on the road (in traffic accidents) (statistically significant difference). Most of them had head contusion and cerebral commotion combined (46.8%), followed by head contusion alone (12.5%) and skull fractures (10.5%). Hemorrhages and hematomas were rare (epidural, subdural, subarachnoid hemorrhage), found in 3.2% of cases. We hope that our results will prove helpful in planning preventive measures and treatment of injured children.

Mechanical injuries of the eyeball: Frequency, structure, and possibility of the prevention

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Jovanović Miloš

2006-01-01

Full Text Available Introduction. Some factors significant for development of mechanical injuries of the eyeball have been analyzed in the study. Objective. Basic objective of such analysis was prevention and reduction of these injuries. Method. Mechanical injuries of the eyeball in patients hospitalized at the Institute of Eye Disease, CCS in Belgrade, in five year period have been analyzed. Only patients with severe eye injuries were hospitalized. The following parameters were analyzed: sex, age, occupation of patients, residence, time of the inflicted injury, i.e. by months in a year, days in a week and hours in a day, place and way of inflicting the injury as well as visual acuity on admission. In addition, the type of injury was analyzed, i.e. contusion or penetrating with all resulting complications. Finally, the timing of primary surgical management of the eye injury was specified, if required. Results. A total number of hospitalized patients with mechanical eye injuries was 1642 during the last five years, meaning that one injury occurred daily. There were 1381 males and 261 females, meaning that males were 5.3 times more the victims of mechanical eye injuries. Out of all the injured, 861 (52.4% were from rural environment, while 781 (47.6% were urban population. The proportion of injuries of the right or the left eye was nearly equal, while both eyes were simultaneously injured in 21 (1.3% cases. The injuries were inflicted in all ages, but most frequently in working population ranging from 16 to 55 years, accounting for 60.8%. Unfortunately, a lot of the injured were children up to 15 years of age - 19.4%. The most commonly injured were workers - 39.8%, followed by students - 17.5%. A piece of wood was the cause of injury in 21.8%, sharp and pointed objects in 17.2%, hammer and metal in 14.2%, glass in 11.6%, and other different causes in varying percentage. There were also rare causes of injuries, such as those caused by zip, dog bite, rooster’s bill

Does timing of transplantation of neural stem cells following spinal cord injury affect outcomes in an animal model?

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Cheng, Ivan; Park, Don Y; Mayle, Robert E; Githens, Michael; Smith, Robert L; Park, Howard Y; Hu, Serena S; Alamin, Todd F; Wood, Kirkham B; Kharazi, Alexander I

2017-12-01

We previously reported that functional recovery of rats with spinal cord contusions can occur after acute transplantation of neural stem cells distal to the site of injury. To investigate the effects of timing of administration of human neural stem cell (hNSC) distal to the site of spinal cord injury on functional outcomes in an animal model. Thirty-six adult female Long-Evans hooded rats were randomized into three experimental and three control groups with six animals in each group. The T10 level was exposed via posterior laminectomy, and a moderate spinal cord contusion was induced by the Multicenter Animal Spinal Cord Injury Study Impactor (MASCIS, W.M. Keck Center for Collaborative Neuroscience, Piscataway, NJ, USA). The animals received either an intrathecal injection of hNSCs or control media through a separate distal laminotomy immediately, one week or four weeks after the induced spinal cord injury. Observers were blinded to the interventions. Functional assessment was measured immediately after injury and weekly using the Basso, Beattie, Bresnahan (BBB) locomotor rating score. A statistically significant functional improvement was seen in all three time groups when compared to their controls (acute, mean 9.2 vs. 4.5, P=0.016; subacute, mean 11.1 vs. 6.8, P=0.042; chronic, mean 11.3 vs. 5.8, P=0.035). Although there was no significant difference in the final BBB scores comparing the groups that received hNSCs, the group which achieved the greatest improvement from the time of cell injection was the subacute group (+10.3) and was significantly greater than the chronic group (+5.1, P=0.02). The distal intrathecal transplantation of hNSCs into the contused spinal cord of a rat led to significant functional recovery of the spinal cord when injected in the acute, subacute and chronic phases of spinal cord injury (SCI), although the greatest gains appeared to be in the subacute timing group.

Driver Injury Risk Variability in Finite Element Reconstructions of Crash Injury Research and Engineering Network (CIREN) Frontal Motor Vehicle Crashes.

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Gaewsky, James P; Weaver, Ashley A; Koya, Bharath; Stitzel, Joel D

2015-01-01

hemomediastinum. Stress-based metrics were used to predict injury to the lower leg of the Camry case occupant. The regional-level injury metrics evaluated for the Cobalt case occupant indicated a low risk of injury; however, strain-based injury metrics better predicted pulmonary contusion. Approximately 49% of the Cobalt occupant's left lung was contused, though the baseline simulation predicted 40.5% of the lung to be injured. A method to compute injury metrics and risks as functions of precrash occupant position was developed and applied to 2 CIREN MVC FE reconstructions. The reconstruction process allows for quantification of the sensitivity and uncertainty of the injury risk predictions based on occupant position to further understand important factors that lead to more severe MVC injuries.

Improvement of visual acuity and VEP after optic nerve contusion by NGF and its safety analysis

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Ming Zhao

2018-02-01

Full Text Available AIM:To investigate the effect of neuropathic factor(NGFon visual acuity and visual evoked potential(VEPin patients with optic nerve contusion. METHODS:Totally 78 patients(78 eyeswith optic nerve contusion were selected. From January 2013 to June 2016, 39 cases(39 eyeswere divided into observation group and control group respectively according to the random number table method. Prednisone, vitamins and mecobalamin tablets treatment were given to both groups, based on that, the observation group was given NGF treatment, continuous treatment of 2 courses(21d for a course of treatment. RESULTS: There was no significant difference in visual field defect and visual field sensitivity between the observation group and the control group before treatment(P>0.05. After treatment, the visual field defect degree of the observation group was smaller, the visual field sensitivity was better than that of the control group(PP>0.05. After treatment, the P100 wave latency of the observation group was significantly shorter than that of the control group(PPPCONCLUSION: NGF treatment for optic nerve contusion can significantly improve the patient's visual acuity, VEP indicators, reduce visual field defects, improve visual field sensitivity.

Ice hockey injuries.

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Benson, Brian W; Meeuwisse, Willem H

2005-01-01

This article reviews the distribution and determinants of injuries reported in the pediatric ice hockey literature, and suggests potential injury prevention strategies and directions for further research. Thirteen electronic databases, the ISI Web of Science, and 'grey literature' databases were searched using a combination of Medical Subject Headings and text words to identify potentially relevant articles. The bibliographies of selected studies were searched to identify additional articles. Studies were selected for review based on predetermined inclusion and exclusion criteria. A comparison between studies on this topic area was difficult due to the variability in research designs, definition of injury, study populations, and measurements used to assess injury. The majority of injuries were sustained during games compared with practices. The two most commonly reported injuries were sprains/strains and contusions. Players competing at the Minor hockey, High School, and Junior levels of competition sustained most of their injuries to the upper extremity, head, and lower extremity, respectively. The primary mechanism of injury was body checking, followed by stick and puck contact. The frequency of catastrophic eye injuries has been significantly reduced with the world-wide mandation of full facial protection for all Minor hockey players. Specific hockey-related injury risk factors are poorly delineated and rarely studied among pediatric ice hockey players leaving large gaps in the knowledge of appropriate prevention strategies. Risk management strategies should be focused at avoiding unnecessary foreseeable risk, and controlling the risks inherent to the sport. Suggestions for injury prevention and future research are discussed.

Demographic Profile and Pathological Patterns of Head Injury in Albania

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Sabri Hoxha

2014-03-01

Full Text Available Introduction: Head injury (HI is a serious morbid state caused by structural changes of the scalp, skull, and/or its contents, due to mechanical forces. Generally, the most frequent cause of HI is road traffic accident (RTA, followed by homicidal and falling injuries. The aim of present study is to assess epidemiology data, causes and patterns responsible for HI among Albanian subjects. Methodology: All HI cases (1000 are collected by the Forensic Institute of Albania, based on medical and forensic records of traumatized subjects between 2007- 2012. The prospectively-collected and descriptive information is focused on demographic data, responsible factors, type and level of cranial and brain injury, as well as their outcome. Results: The majority of HI victims were male (84% of age range of 15yrs -35yrs (70%. RTA was the HI cause in 88%, followed by homicides (3.8%, falling (3% etc. With respect to injury mechanisms, extra-dural hematoma was found in 93% of cases, followed by cerebral edema (61%, cerebral contusion (37%, skull bone fractures (35%, etc. Severe alteration of the consciousness was observed in 57% of the cases, while amnesia lasted longer than 4 weeks in 44% of the subjects included in our study. Discussion: This survey demonstrates that the majority of HI victims' is young and middle age males target group exposed to RTA. The increase of vehicles' use in placecountry-regionAlbania is more evident than RTA-related HI, indicating that driving newer vehicles with safer technology or helmets use while motorcycling can potentially decline the fatal outcome.

CT manifestation of diffuse brain injury in cases of serious acute subdural hematoma

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Nikaido, Yuji; Shimomura, Takahide; Fujita, Toyohisa; Hirabayashi, Hidehiro; Utsumi, Shozaburo

1987-04-01

Eighty-two adult cases of serious acute subdural hematoma (SDH) of Glasgow Coma Scale 9 or more severe (50 operated-on and 32 non-operated-on cases) were selected in order to study the relation between CT findings at the acute stage and the prognosis of SDH. The CT findings were analyzed in the following respects: size of SDH, midline shift, manifestation of perimesencephalic cisterns, and presence or absence of diffuse hemispheric swelling, diffuse cerebral swelling, subarachnoid hemorrhage, intraventricular hemorrhage, epidural hematoma, hemorrhagic contusion, and dilatation of the contralateral temporal horn. As a result, the most important prognostic signs were found to be: (1) diffuse hemispheric swelling, (2) diffuse cerebral swelling, (3) subarachnoid hemorrhage of the basal-cistern type, (4) intraventricular hemorrhage, (5) deep-seated contusion, (6) complete effacement of the perimesencephalic cisterns, and (7) dilatation of the contralateral temporal horn. These findings, except for the last item, which indicates the final phase of tentorial herniation, were regarded as various patterns of the CT manifestation of diffuse brain injury; the positively associated diffuse brain injury seemed to determine the prognosis of SDH.

Dynamic assessment of acute blunt cerebral contusions and lacerations with CT perfusion: an experimental study

International Nuclear Information System (INIS)

Yuan Tao; Quan Guanmin; Liu Huaijun; Gao Guodong; Lei Jianming

2009-01-01

Objective: To explore the dynamic changes of blood perfusion in traumatic cerebral contusion and laceration of experimental model. Methods: Impact-acceleration head traumatic cerebral contusion and laceration models of 40 rabbits were established. CTP was made for all animals at 1, 3, 6, 12, 24, 48 and 72 h after head injury. The original images were transferred to workstation for postprocessing. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of central area, peripheral area of contusion and laceration, and their mirror areas were measured on the section in which lesions were in their maximal area. The CTP parameters among different areas were compared with paired samples t test. The evolvement of CBF, CBV and MTT of cerebral contusion and laceration areas were recorded as well. Then, the histological abnormalities of central and peripheral areas were observed separately by referring to corresponding CTP maps. Results: Experimental models were successfully made in 35 rabbits. Abnormal signal intensity was detected on their T 2 WI and DWI images, which was consistent with brain contusion. For CTP parameters: (1) The CBF of central area of the lesions decreased markedly after trauma and reached its nadir at 12 h. Then the CBF of central area rose slowly from 24 h. The value of CBF of the central area at 1, 3, 6, 12, 24 and 72 h were (27.58±18.70), (20.64±6.50), (23.38± 7.53), (22.14±10.25), (25.08±11.01), (43.08±18.33) and (54.79± 14.63) ml·min -1 ·100 g -1 respectively. Whereas the CBF value of the corresponding mirror areas were (62.28±25.46), (60.67±16.19), (67.00±21.34), (74.46±20.11), (66.73±11.68), (81.63± 10.99) and 86.16±10.57) ml·min -1 ·100 g -1 respectively. There was significant difference of CBF between the central and the mirror areas (t=4.41, 5.57, 5.47, 6.02, 6.44, 4.81, 10.60 respectively, P 0.05). (2) The CBV of central area of the lesions also decreased obviously after trauma and reached its

Sports injury of the pediatric musculoskeletal system.

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Rosendahl, Karen; Strouse, Peter J

2016-05-01

Sports related injuries are common in children and adolescents, with a reported incidence of around one in ten children each year. Boys incur more and severer sports injuries than girls, and chance for injury is greater with contact or jumping sports. Sports injuries seen in children under 10-years of age are non-specific, including contusions, mild sprains, and extremity fractures, usually Salter fractures of the physes (growth plate) or plastic fractures. In the very young athlete, sports injury of the ligaments or muscle is rare as are spine or head injuries. With growth and adolescence, the intensity of sports involvement increases. Pre-pubertal children still have open physes that are prone to injury, both acute or due to stress from a repetitive activity. In addition to injury of the physes of the long bones, injuries to the physes of apophyses are common. Ligamentous injury is uncommon before physeal closure, but can occur. After the physes fuse, ligamentous injury is seen with patterns similar to adults. This review will include a description of sports related injuries seen in children and adolescents. We will concentrate on injuries that are specific for the growing skeleton, with a brief mention of those seen after fusion of the physes.

Lower extremity ulceration caused by medical scooter injury: a case series.

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Paparone, Pamela

2013-01-01

The motorized mobility scooter (MMS) provides considerable benefits to patients with mobility limitations. Nevertheless, safety concerns related to MMS use are an issue. With increased use because of increased life expectancy and chronic illness, there are a growing number of reports of MMS-related injuries, ranging from lacerations and contusions to fatalities. Comorbidities may also exacerbate wound care. Prevention of these injuries is greatly needed. The author presents 5 patients with lower-extremity ulceration caused by MMS injuries. To prevent these injuries, health care providers must carefully evaluate and monitor patients. Clinicians and MMS manufacturers also need to educate and train patients on the safe use of MMS devices, including the regular use of footwear. Copyright © 2013 Mosby, Inc. All rights reserved.

Lesões em surfistas profissionais Injuries among professional surfers

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Luís Henrique Base

2007-08-01

Full Text Available O objetivo do presente estudo foi verificar a ocorrência de lesões relatadas por surfistas profissionais brasileiros, integrantes do circuito brasileiro. O estudo foi realizado durante a etapa do Campeonato Brasileiro de Surfe Profissional masculino, realizado em Maresias, São Sebastião, SP, em junho de 2005. Participaram do estudo 32 surfistas profissionais; cada participante respondeu a um questionário sobre as lesões que havia sofrido durante a prática do esporte. Foram encontradas 112 lesões entre todos os participantes do estudo. O ferimento corto-contuso foi a lesão de maior ocorrência, 38 (33,9%; seguido das entorses, 29 (25,9%; das contusões, 16 (14,2%; estiramentos musculares, 14 (12,5%; queimaduras, 9 (8,0%; fraturas, 6 (5,3%. Concluímos que a maioria das lesões ocorreu durante manobras, no contato com a prancha e com o fundo, sugerindo que os fatores extrínsecos inerentes a esse esporte são potencialmente lesivos para os atletas.The aim of this study was to verify the occurrence of injuries in Brazilian professional surfers who took part in one of the stages of the Professional Brazilian Surf Championship for men. There were 32 professional surfers participating in the study and each one of them filled in a questionnaire about the injuries they had suffered during the surf practice. There were found 112 injuries among all the participants of the study. Lacerations/cuts was the most frequent injury, 38 (33.9%; followed by sprains, 29 (25.9%; contusions, 16 (14.2%; strains, 14 (12.5%; burns, 9 (8.0%; fractures, 6 (5.3%. We conclude that most of the injuries were originated by trauma, suggesting that the extrinsic factors inherent to this sport are potentially harmful to the athletes.

Snowboarding injuries. An overview.

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Bladin, C; McCrory, P

1995-05-01

Over the last 10 years, snowboarding has become established as a popular and legitimate alpine sport. However, at present, there are few epidemiological studies examining the spectrum of injuries associated with this new sport. Snowboarders are typically male (male: female ratio of 3:1) and in their early twenties. They have an injury rate of 4 to 6 per 1000 visits, which is comparable to that which occurs with skiing. However, in contrast to skiing, in which only 34% of those injured are beginners, the majority (60%) of snowboarders injured are beginners. This is a reflection of the participant profile of this developing sport. 57% of injuries occur in the lower limbs, and 30% in the upper limbs. The most common injuries are simple sprains (31 to 53%), particularly of the ankles (23 to 26%) and knees (12 to 23%), followed by fractures (24 to 27%) and contusions (12%). Compared with skiing injuries, snowboarders have 2.4 times as many fractures, particularly of the upper limbs (constituting 21 vs 35% of upper limb injuries), fewer knee injuries (23 vs 44% of lower limb injuries), but more ankle injuries (23 vs 6% of lower limb injuries). Snowboarding knee injuries are less severe than those associated with skiing. Fracture of the lateral process of the talus is an unusual and uncommon snowboarding injury that can be misdiagnosed as a severe ankle sprain. Ankle injuries are more common with soft shell boots, whereas knee injuries and distal tibia fractures are more common with hard shell boots.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of injury types for mixed martial arts athletes.

Science.gov (United States)

Ji, MinJoon

2016-05-01

[Purpose] The purpose of the present study was to examine the types of injuries associated with mixed martial arts and their location in order to provide substantial information to help reduce the risk of these injuries during mixed martial arts. [Subjects and Methods] Data were collected from 455 mixed martial arts athletes who practiced mixed martial arts or who participated in mixed martial arts competitions in the Seoul Metropolitan City and Gyeongnam Province of Korea between June 3, 2015, and November 6, 2015. Questionnaires were used to collect the data. The convenience sampling method was used, based on the non-probability sampling extraction method. [Results] The arm, neck, and head were the most frequent locations of the injuries; and lacerations, concussions, and contusions were the most frequently diagnosed types of injuries in the mixed martial arts athletes in this study. [Conclusion] Reducing the risk of injury by establishing an alert system and preventing critical injuries by incorporating safety measures are important.

Locomotor recovery after spinal cord hemisection/contusion injures in bonnet monkeys: footprint testing--a minireview.

Science.gov (United States)

Rangasamy, Suresh Babu

2013-07-01

Spinal cord injuries usually produce loss or impairment of sensory, motor and reflex function below the level of damage. In the absence of functional regeneration or manipulations that promote regeneration, spontaneous improvements in motor functions occur due to the activation of multiple compensatory mechanisms in animals and humans following the partial spinal cord injury. Many studies were performed on quantitative evaluation of locomotor recovery after induced spinal cord injury in animals using behavioral tests and scoring techniques. Although few studies on rodents have led to clinical trials, it would appear imperative to use nonhuman primates such as macaque monkeys in order to relate the research outcomes to recovery of functions in humans. In this review, we will discuss some of our research evidences concerning the degree of spontaneous recovery in bipedal locomotor functions of bonnet monkeys that underwent spinal cord hemisection/contusion lesions. To our knowledge, this is the first report to discuss on the extent of spontaneous recovery in bipedal locomotion of macaque monkeys through the application of footprint analyzing technique. In addition, the results obtained were compared with the published data on recovery of quadrupedal locomotion of spinally injured rodents. We propose that the mechanisms underlying spontaneous recovery of functions in spinal cord lesioned monkeys may be correlated to the mature function of spinal pattern generator for locomotion under the impact of residual descending and afferent connections. Moreover, based on analysis of motor functions observed in locomotion in these subjected monkeys, we understand that spinal automatism and development of responses by afferent stimuli from outside the cord could possibly contribute to recovery of paralyzed hindlimbs. This report also emphasizes the functional contribution of progressive strengthening of undamaged nerve fibers through a collateral sprouts/synaptic plasticity formed

Transplantation of human embryonic stem cell-derived oligodendrocyte progenitors into rat spinal cord injuries does not cause harm.

Science.gov (United States)

Cloutier, Frank; Siegenthaler, Monica M; Nistor, Gabriel; Keirstead, Hans S

2006-07-01

Demyelination contributes to loss of function following spinal cord injury. We have shown previously that transplantation of human embryonic stem cell-derived oligodendrocyte progenitors into adult rat 200 kD contusive spinal cord injury sites enhances remyelination and promotes recovery of motor function. Previous studies using oligodendrocyte lineage cells have noted a correlation between the presence of demyelinating pathology and the survival and migration rate of the transplanted cells. The present study compared the survival and migration of human embryonic stem cell-derived oligodendrocyte progenitors injected 7 days after a 200 or 50 kD contusive spinal cord injury, as well as the locomotor outcome of transplantation. Our findings indicate that a 200 kD spinal cord injury induces extensive demyelination, whereas a 50 kD spinal cord injury induces no detectable demyelination. Cells transplanted into the 200 kD injury group survived, migrated, and resulted in robust remyelination, replicating our previous studies. In contrast, cells transplanted into the 50 kD injury group survived, exhibited limited migration, and failed to induce remyelination as demyelination in this injury group was absent. Animals that received a 50 kD injury displayed only a transient decline in locomotor function as a result of the injury. Importantly, human embryonic stem cell-derived oligodendrocyte progenitor transplants into the 50 kD injury group did not cause a further decline in locomotion. Our studies highlight the importance of a demyelinating pathology as a prerequisite for the function of transplanted myelinogenic cells. In addition, our results indicate that transplantation of human embryonic stem cell-derived oligodendrocyte progenitor cells into the injured spinal cord is not associated with a decline in locomotor function.

Concussion in Motor Vehicle Accidents: The Concussion Identification Index

Science.gov (United States)

2016-08-03

Motor Vehicle Accidents; TBI (Traumatic Brain Injury); Brain Contusion; Brain Injuries; Cortical Contusion; Concussion Mild; Cerebral Concussion; Brain Concussion; Accidents, Traffic; Traffic Accidents; Traumatic Brain Injury With Brief Loss of Consciousness; Traumatic Brain Injury With no Loss of Consciousness; Traumatic Brain Injury With Loss of Consciousness

A combination of methylprednisolone and quercetin is effective for the treatment of cardiac contusion following blunt chest trauma in rats

Energy Technology Data Exchange (ETDEWEB)

Demir, F. [Department of Pediatric Cardiology, Faculty of Medicine, Dicle University, Diyarbakır (Turkey); Güzel, A. [Department of Pediatrics, Faculty of Medicine, Ondokuz Mayıs University, Samsun (Turkey); Katı, C. [Department of Emergency Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun (Turkey); Karadeniz, C. [Pediatric Cardiology Services, Behçet Uz Children' s Hospital, İzmir (Turkey); Akdemir, U. [Department of Emergency Medicine, Faculty of Medicine, Ondokuz Mayıs University, Samsun (Turkey); Okuyucu, A. [Department of Medical Biochemistry, Faculty of Medicine, Ondokuz Mayıs University, Samsun (Turkey); Gacar, A. [Department of Pathology, Faculty of Veterinary Medicine, Ondokuz Mayıs University, Samsun (Turkey); Özdemir, S. [Department of Pediatrics, Faculty of Medicine, Ondokuz Mayıs University, Samsun (Turkey); Güvenç, T. [Department of Pathology, Faculty of Veterinary Medicine, Ondokuz Mayıs University, Samsun (Turkey)

2014-08-01

Cardiac contusion is a potentially fatal complication of blunt chest trauma. The effects of a combination of quercetin and methylprednisolone against trauma-induced cardiac contusion were studied. Thirty-five female Sprague-Dawley rats were divided into five groups (n=7) as follows: sham, cardiac contusion with no therapy, treated with methylprednisolone (30 mg/kg on the first day, and 3 mg/kg on the following days), treated with quercetin (50 mg·kg{sup −1}·day{sup −1}), and treated with a combination of methylprednisolone and quercetin. Serum troponin I (Tn-I) and tumor necrosis factor-alpha (TNF-α) levels and cardiac histopathological findings were evaluated. Tn-I and TNF-α levels were elevated after contusion (P=0.001 and P=0.001). Seven days later, Tn-I and TNF-α levels decreased in the rats treated with methylprednisolone, quercetin, and the combination of methylprednisolone and quercetin compared to the rats without therapy, but a statistical significance was found only with the combination therapy (P=0.001 and P=0.011, respectively). Histopathological degeneration and necrosis scores were statistically lower in the methylprednisolone and quercetin combination group compared to the group treated only with methylprednisolone (P=0.017 and P=0.007, respectively). However, only degeneration scores were lower in the combination therapy group compared to the group treated only with quercetin (P=0.017). Inducible nitric oxide synthase positivity scores were decreased in all treatment groups compared to the untreated groups (P=0.097, P=0.026, and P=0.004, respectively). We conclude that a combination of quercetin and methylprednisolone can be used for the specific treatment of cardiac contusion.

Epidemiology of injuries in juniors participating in top-level karate competition: a prospective cohort study.

Science.gov (United States)

Čierna, Dušana; Barrientos, Merce; Agrasar, Carlos; Arriaza, Rafael

2018-06-01

Karate is a popular combat semi-contact sport among juniors, but there are only few studies available on the epidemiology of injuries in karate junior athletes. The aims of this study were to determine the incidence and pattern of injuries in top-level karate competition for athletes aged 16 to 20 years, and to compare injury rates between age groups (ie, under 18-year-old [U18] and under 21-year-old [U21]) and genders, following the introduction of new weight categories. A prospective injury surveillance was undertaken at four consecutive World Karate Championships (2009 to 2015), following the same protocols used in previous investigations. During the four championships, a total of 257 injuries were recorded, with an incidence of 41.4/1,000 athlete exposures (AEs, 95% CI 36.4 to 46.3). The injury rate was significantly lower for females with a rate ratio 0.63 (95% CI 0.48 to 0.82). Most of the injuries were minor ones: contusions (n=100), followed by abrasions (n=63) and epistaxis (n=62). Only 10% of the injuries were time-loss injuries (injury incidence rates 4.2/1,000 AEs; 95% CI 2.7 to 6.1). Face injuries represented 69.6% of the injuries, most of them were minor ones (light abrasions 24.5%, epistaxis 24.1%, contusion 16.7%). Change of rules (raising the number of weight categories from three to five) reduced injury incidence in the U21 category. The total injury rate in junior competitions is lower compared with elite adult athletes and higher compared with younger elite athletes. Time-loss injuries are rare. The implementation of the new competition categories in U21 karate has been associated with a significant reduction in injury rate. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Injuries during football tournaments in 45,000 children and adolescents.

Science.gov (United States)

Kolstrup, Line Agger; Koopmann, Kristian Ugelvig; Nygaard, Uffe Harboe; Nygaard, Rie Harboe; Agger, Peter

2016-11-01

Four percent of the world's population, or 265 million people, play football, and many players are injured every year. The present study investigated more than 1800 injuries in over 45,000 youth players participating in three consecutive international football tournaments in Denmark in 2012-2014. The aim was to investigate the injury types and locations in children and adolescent football players and the differences between genders and age groups (11-15 and 16-19 years of age). An overall injury rate of 15.3 per 1000 player hours was found. The most common injury location was lower extremities (66.7%), and the most common injury type was contusion (24.4%). Girls had a relative risk of injury of 1.5 compared with boys, p football tournament. These findings are of great value for organizations and healthcare professionals planning similar events and for planning injury prevention strategies, which would be of special interest in the youngest female players in general.

Reducing macrophages to improve bone marrow stromal cell survival in the contused spinal cord.

NARCIS (Netherlands)

Ritfeld, G.J.; Nandoe Tewarie, R.D.S.; Rahiem, S.T.; Hurtado, A.; Roos, R.A.; Grotenhuis, A.; Oudega, M.

2010-01-01

We tested whether reducing macrophage infiltration would improve the survival of allogeneic bone marrow stromal cells (BMSC) transplanted in the contused adult rat thoracic spinal cord. Treatment with cyclosporine, minocycline, or methylprednisolone all resulted in a significant decrease in

Characteristics of Traumatic Brain Injury among Accident and Falling Down Cases

Directory of Open Access Journals (Sweden)

Kamran Aghakhani

2015-10-01

Full Text Available Motor vehicle and falling down are responsible for the most number of traumatic injuries. This study aimed to compare the characteristics of traumatic brain injury among accident and falling down cases. In this analytical cross- sectional study, data were collected from the records of cadavers who died due to accident or falling down and referred to Kahrizak dissection hall, Tehran forensic medicine organization during 2013. A total of 237 subjects (183 (77.2% accident and 54 (22.8% falling down with a mean age of 35.62 (SD=15.75 were evaluated. A number of 213 (89.9% were male. From accident group, scalp injury was seen in 146 (79.8%, scalp abrasion in 122 (66.7%, scalp laceration in 104 (56.8%, sub skull bruising in 176 (96.3%, skull fracture in 119 (65%, hemorrhage in 166 (90.7%, Subdural hemorrhage (SDH in 155 (84.7%, Subarachnoid hemorrhage (SAH in 161 (88%, Epidural hemorrhage (EDH in 41 (22.4%, contusion in 140 (76.5%, and skull base fracture in 140 (76.5% of cases. In falling down group scalp injury was seen in 42 (77.8% cadavers, scalp abrasion in 38 (70.4%, scalp laceration in 30 (55.6%, sub skull bruising in 49 (90.7%, skull fracture in 39 (72.2%, Hemorrhage in 49 (90.7%, SDH in 43 (79.6%, SAH in 47 (87%, EDH in 10 (18.5%, contusion in 33 (61.1%, and skull base fracture in 39 (72.2% of cases. There was no significant difference between these two groups (P Value> 0.05. Accident and falling down had no difference in terms of any injury or hemorrhage.

Isolated medulla oblongata function after severe traumatic brain injury

OpenAIRE

Wijdicks, E; Atkinson, J; Okazaki, H

2001-01-01

The objective was to report the first pathologically confirmed case of partly functionally preserved medulla oblongata in a patient with catastrophic traumatic brain injury.
A patient is described with epidural haematoma with normal breathing and blood pressure and a retained coughing reflex brought on only by catheter suctioning of the carina. Multiple contusions in the thalami and pons were found but the medulla oblongata was spared at necropsy. 
In conclusion, medulla oblong...

Pathogenesis of traumatic intracerebral hematoma with a sequential study of computerized tomography

Energy Technology Data Exchange (ETDEWEB)

Ohmori, H; Miyazaki, S; Munekata, K; Fukushima, H [Hitachi General Hospital, Hitachi, Ibaraki (Japan); Shohji, A

1981-04-01

A sequential study with computerized tomography (CT scan) of two cases of traumatic intracerebral hematoma is reported. Case 1 was a 69-year-old man who had a head injury. The initial CT scan, taken 1 hour after his injury, showed a left temporal salt-and-pepper appearance, which proved to be a cerebral contusion. The CT scan 4.5 hours after his injury showed a left temporal high density area instead. An operation was performed, and a massive intracerebral hematoma was observed. Case 2 was a 61-year-old man who was also admitted because of a head injury. The initial CT scan, taken 1 hour after his injury, revealed several bifrontal intracerebral hemorrhagic spots in the low-density areas, suggesting contusion. A secondary CT scan (23 hours) demonstrated that the traumatic intracerebral hematoma had developed into a posttraumatic cerebral contusion. The operation disclosed a hematoma surrounded by contusion. These cases prove that traumatic intracerebral hematoma is often caused by cerebral contusion.

On the pathogenesis of traumatic intracerebral hematoma with a sequential study of computerized tomography

International Nuclear Information System (INIS)

Ohmori, Hidetoshi; Miyazaki, Shinichiro; Munekata, Katsuharu; Fukushima, Hiromi; Shohji, Akira.

1981-01-01

A sequential study with computerized tomography (CT scan) of two cases of traumatic intracerebral hematoma is reported. Case 1 was a 69-year-old man who had a head injury. The initial CT scan, taken 1 hour after his injury, showed a left temporal salt-and-pepper appearance, which proved to be a cerebral contusion. The CT scan 4.5 hours after his injury showed a left temporal high density area instead. An operation was performed, and a massive intracerebral hematoma was observed. Case 2 was a 61-year-old man who was also admitted because of a head injury. The initial CT scan, taken 1 hour after his injury, revealed several bifrontal intracerebral hemorrhagic spots in the low-density areas, suggesting contusion. A secondary CT scan (23 hours) demonstrated that the traumatic intracerebral hematoma had developed into a posttraumatic cerebral contusion. The operation disclosed a hematoma surrounded by contusion. These cases prove that traumatic intracerebral hematoma is often caused by cerebral contusion. (author)

Occupational injury among cooks and food service workers in the healthcare sector.

Science.gov (United States)

Alamgir, Hasanat; Swinkels, Helena; Yu, Shicheng; Yassi, Annalee

2007-07-01

Incidence of occupational injury is anticipated to be high among cooks and food service workers (CFSWs) because of the nature of their work and the types of raw and finished materials that they handle. Incidents of occupational injury, resulting in lost time or medical care over a period of 1 year in two health regions were extracted from a standardized operational database and with person years obtained from payroll data, detailed analysis was conducted using Poisson regression modeling. Among the CFSWs the annual injury rate was 38.1 per 100 person years. The risk of contusions [RR, 95% CI 9.66 (1.04, 89.72)], burns [1.79 (1.39, 2.31)], and irritations or allergies [3.84 (2.05, 7.18)] was found to be significantly higher in acute care facilities compared to long-term care facilities. Lower risk was found among older workers for irritations or allergies. Female CFSWs, compared to their male counterparts, were respectively 8 and 20 times more likely to report irritations or allergies and contusions. In respect to outcome, almost all irritations or allergies required medical visits. For MSI incidents, about 67.4% resulted in time-loss from work. Prevention policies should be developed to reduce the hazards present in the workplace to promote safer work practices for cooks and food service workers.

Injuries in competitive boxing. A prospective study.

Science.gov (United States)

Siewe, J; Rudat, J; Zarghooni, K; Sobottke, R; Eysel, P; Herren, C; Knöll, P; Illgner, U; Michael, J

2015-03-01

Boxing remains a subject of controversy and is often classified as dangerous. But the discussion is based mostly on retrospective studies. This survey was conducted as a prospective study. From October 2012 to September 2013, 44 competitive boxers were asked to report their injuries once a month. The questionnaire collected general information (training, competition) and recorded the number of bouts fought, injuries and resulting lost days. A total of 192 injuries were recorded, 133 of which resulted in interruption of training or competition. Each boxer sustained 3 injuries per year on average. The injury rate was 12.8 injuries per 1 000 h of training. Boxers fighting more than 3 bouts per year sustain more injuries (p=0.0075). The injury rate does is not a function of age (age≤19 vs. > 19a, p=0.53). Injuries to the head and the upper limbs occur most frequently. The most common injuries are soft tissue lacerations and contusions. Head injuries with neurological symptoms rarely occur (4.2%). Boxing has a high injury rate that is comparable with other contact sports, but most injuries are minor. Injury frequency is not a function of whether the boxer competes in the junior or adult category. Athletes fighting many bouts per year have a greater risk of injury. © Georg Thieme Verlag KG Stuttgart · New York.

Traumatic brain injury alters methionine metabolism: implications for pathophysiology

Directory of Open Access Journals (Sweden)

Pramod K Dash

2016-04-01

Full Text Available Methionine is an essential proteinogenic amino acid that is obtained from the diet. In addition to its requirement for protein biosynthesis, methionine is metabolized to generate metabolites that play key roles in a number of cellular functions. Metabolism of methionine via the transmethylation pathway generates S-adenosylmethionine (SAM that serves as the principal methyl (-CH3 donor for DNA and histone methyltransferases to regulate epigenetic changes in gene expression. SAM is also required for methylation of other cellular proteins that serve various functions and phosphatidylcholine synthesis that participate in cellular signaling.. Under conditions of oxidative stress, homocysteine (which is derived from SAM enters the transsulfuration pathway to generate glutathione, an important cytoprotective molecule against oxidative damage. As both experimental and clinical studies have shown that traumatic brain injury (TBI alters DNA and histone methylation and causes oxidative stress, we examined if TBI alters the plasma levels of methionine and its metabolites in human patients. Blood samples were collected from healthy volunteers (n = 20 and patients with mild TBI (GCS > 12; n = 20 or severe TBI (GCS < 8; n = 20 within the first 24 hours of injury. The levels of methionine and its metabolites in the plasma samples were analyzed by either liquid chromatography-mass spectrometry or gas chromatography-mass spectrometry (LC-MS or GC-MS. Severe TBI decreased the levels of methionine, SAM, betaine and 2-methylglycine as compared to healthy volunteers, indicating a decrease in metabolism through the transmethylation cycle. In addition, precursors for the generation of glutathione, cysteine and glycine were also found to be decreased as were intermediate metabolites of the gamma-glutamyl cycle (gamma-glutamyl amino acids and 5-oxoproline. Mild TBI also decreased the levels of methionine, α-ketobutyrate, 2 hydroxybutyrate and glycine, albeit to lesser

[Road traffic injuries in Catalonia (Spain): an approach using the minimum data set for acute-care hospitals and emergency resources].

Science.gov (United States)

Clèries, Montse; Bosch, Anna; Vela, Emili; Bustins, Montse

2015-09-01

To verify the usefulness of the minimum data set (MDS) for acute-care hospitals and emergency resources for the study of road traffic injuries and to describe the use of health resources in Catalonia (Spain). The study population consisted of patients treated in any kind of emergency service and patients admitted for acute hospitalization in Catalonia in 2013. A descriptive analysis was performed by age, gender, time and clinical variables. A total of 48,150 patients were treated in hospital emergency departments, 6,210 were attended in primary care, and 4,912 were admitted to hospital. There was a higher proportion of men (56.2%), mainly aged between 20 and 40 years. Men accounted for 54.9% of patients with minor injuries and 75.1% of those with severe injuries. Contusions are the most common injury (30.2%), followed by sprains (28.7%). Fractures mostly affected persons older than 64 years, internal injuries particularly affected men older than 64 years, and wounds mainly affected persons younger than 18 years and older than 64 years. In the adult population, the severity of the injuries increased with age, leading to longer length of stay and greater complexity. Hospital mortality was 0.2%. Fractures, internal injuries and wounds were more frequent in the group of very serious injuries, and sprains and contusions in the group of minor injuries. MDS records (acute hospitals and emergency resources) provide information that is complementary to other sources of information on traffic accidents, increasing the completeness of the data. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Common rugby league injuries. Recommendations for treatment and preventative measures.

Science.gov (United States)

Gibbs, N

1994-12-01

Rugby league is the main professional team sport played in Eastern Australia. It is also very popular at a junior and amateur level. However, injuries are common because of the amount of body contact that occurs and the amount of running that is required to participate in the game. Injuries to the lower limbs account for over 50% of all injuries. The most common specific injuries are ankle lateral ligament tears, knee medial collateral and anterior cruciate ligament tears, groin musculotendinous tears, hamstring and calf muscle tears, and quadriceps muscle contusions. Head injuries are common and consist of varying degrees of concussion as well as lacerations and facial fractures. Serious head injury is rare. Some of the more common upper limb injuries are to the acromioclavicular and glenohumeral joints. Accurate diagnosis of these common injuries using appropriate history, examination and investigations is critical in organising a treatment and rehabilitation plan that will return the player to competition as soon as possible. An understanding of the mechanism of injury is also important in order to develop preventative strategies.

Application of low field intensity joint MRI in ankle injury

International Nuclear Information System (INIS)

Zhang Zhenyu; Wang Wei

2011-01-01

Objective: To observe the diagnostic value of the low field intensity joint magnetic resonance imaging (MRI) in traumatic ankles. Methods: Through a retrospective examination and collection of 50 cases with complete information and checked by arthroscope or/and operated from Jan 2007 to Jun 2010, the diagnostic value ligament of the ankle joint, bone contusion,occult fracture, talus cartilage, and tendon could be evaluated. Cases of fracture for which could be diagnosed by X rays and CT were not included in this research. Results: The special low field intensity joint MRI had a high diagnostic sensitivity of 88.9% to ligamentum talofibulare anterius, but was only 50% sensitive to ligamentum calcaneofibulare. Its sensitivity to injury of ligamentum deltoideum and distal tibiofibular syndesmosis was up to 100%. Tendon injury, bone contusion and occult fracture could be exactly diagnosed. Its total sensitivity on talus cartilage traumatism was 70.6%. Its diagnosis sensitivity to talus cartilage traumatism at the 3rd-5th period by Mintz was 90%, with a lower one of 42.9% at the 1st-2nd period. Talus cartilage traumatism could be exactly predicted by osseous tissue dropsy below cartilage. Conclusion: The special low field intensity joint MRI is highly applicable to the diagnosis on ankle joint traumatism and facilitates clinical treatment. (authors)

Motorized dirt bike injuries in children.

Science.gov (United States)

Ramakrishnaiah, Raghu H; Shah, Chetan; Parnell-Beasley, Donna; Greenberg, Bruce S

2013-04-01

The number of dirt bike injuries in children in the United States is increasing and poses a public health problem. The purpose of our study was to identify the imaging patterns of dirt bike injuries in children and associations with morbidity and mortality. The study included 85 children (83 boys, 2 girls) dirt bike injury treated at a tertiary care pediatric hospital. Imaging studies and hospital medical records were reviewed. Outcomes were classified into the following categories: short-term disability, long-term disability or no follow-up available. Imaging studies were reviewed for head, torso, and extremity injuries. One-tailed z test for two proportions was used to determine significant differences between various proportions. Chi-square test with Yates correction was used to determine the significance of long-term disability with injury type. Long bone fractures were the most common injuries. Lower extremity fractures accounted for 79% of extremity fractures and were significantly more common than upper extremity fractures (p = 0.001). Head injuries included fractures (n = 9), brain contusion (n = 5), and meningeal hemorrhage (n = 2). Head injury was associated with long-term disability (p < 0.0001). All torso injuries were solitary. Long-term disability was associated with head injuries but not with torso or extremity injuries. Lower extremity injuries were significantly more common than upper extremity injuries. Torso solid organ injuries were uniformly solitary. Published by Elsevier Inc.

Oleanolic acid alters bile acid metabolism and produces cholestatic liver injury in mice

Energy Technology Data Exchange (ETDEWEB)

Liu, Jie, E-mail: JLiu@kumc.edu [University of Kansas Medical Center, Kansas City, KS 66160 (United States); Zunyi Medical College, Zunyi 563003 (China); Lu, Yuan-Fu [University of Kansas Medical Center, Kansas City, KS 66160 (United States); Zunyi Medical College, Zunyi 563003 (China); Zhang, Youcai; Wu, Kai Connie [University of Kansas Medical Center, Kansas City, KS 66160 (United States); Fan, Fang [Cytopathology, University of Kansas Medical Center, Kansas City, KS 66160 (United States); Klaassen, Curtis D. [University of Kansas Medical Center, Kansas City, KS 66160 (United States)

2013-11-01

Oleanolic acid (OA) is a triterpenoids that exists widely in plants. OA is effective in protecting against hepatotoxicants. Whereas a low dose of OA is hepatoprotective, higher doses and longer-term use of OA produce liver injury. This study characterized OA-induced liver injury in mice. Adult C57BL/6 mice were given OA at doses of 0, 22.5, 45, 90, and 135 mg/kg, s.c., daily for 5 days, and liver injury was observed at doses of 90 mg/kg and above, as evidenced by increases in serum activities of alanine aminotransferase and alkaline phosphatase, increases in serum total bilirubin, as well as by liver histopathology. OA-induced cholestatic liver injury was further evidenced by marked increases of both unconjugated and conjugated bile acids (BAs) in serum. Gene and protein expression analysis suggested that livers of OA-treated mice had adaptive responses to prevent BA accumulation by suppressing BA biosynthetic enzyme genes (Cyp7a1, 8b1, 27a1, and 7b1); lowering BA uptake transporters (Ntcp and Oatp1b2); and increasing a BA efflux transporter (Ostβ). OA increased the expression of Nrf2 and its target gene, Nqo1, but decreased the expression of AhR, CAR and PPARα along with their target genes, Cyp1a2, Cyp2b10 and Cyp4a10. OA had minimal effects on PXR and Cyp3a11. Taken together, the present study characterized OA-induced liver injury, which is associated with altered BA homeostasis, and alerts its toxicity potential. - Highlights: • Oleanolic acid at higher doses and long-term use may produce liver injury. • Oleanolic acid increased serum ALT, ALP, bilirubin and bile acid concentrations. • OA produced feathery degeneration, inflammation and cell death in the liver. • OA altered bile acid homeostasis, affecting bile acid synthesis and transport.

Significance of focal relaxation times in head injury

Energy Technology Data Exchange (ETDEWEB)

Inao, Suguru; Furuse, Masahiro; Saso, Katsuyoshi; Yoshida, Kazuo; Motegi, Yoshimasa; Kaneoke, Yoshiki; Izawa, Akira

1987-11-01

Serial examinations by nuclear magnetic resonance-computed tomography were carried out in 35 head-injured patients aged 7 to 77 years. The injuries were classified as cerebral contusion (nine cases), acute epidural hematoma (eight cases), acute cerebral swelling (two cases), and chronic subdural hematoma (16 cases). The results of 92 measurements were divided into two groups: acute stage (within 3 days of injury) and chronic stage (2 weeks or longer after injury). The spin-lattice relaxation times (T/sub 1/) of brain tissue adjacent to chronic subdural hematoma were evaluated pre- and postoperatively. A Fonar QED 80-alpha system was used for magnetic resonance imaging and measurement of focal T/sub 1/. The T/sub 1/ values at the region of interest were measured 3 to 5 times by the field focusing technique (468 gauss in the focused spot), and the mean value was used for evaluation. The standard T/sub 1/ values obtained from healthy subjects were 290 +- 41 msec in the cerebral cortex and 230 +- 34 msec in the white matter. Prolongation of T/sub 1/ in perifocal brain gradually shortened over time and normalized in the chronic stage. The degree of contusional edema may have been reflected in alterations in T/sub 1/. In contrast, parenchymal injury resulted in a progressive T/sub 1/ elevation, which far exceeded 500 msec in the chronic stage. Such time courses of T/sub 1/ may indicate irreversible tissue damage. There were no noticeable changes in tissue T/sub 1/ over time in patients with acute diffuse cerebral swelling or those who underwent evacuation of acute epidural or chronic subdural hematomas. The underlying pathophysiology in such situations seems to be not brain edema but cerebral hyperemia. In the presence of ischemia, the T/sub 1/ value was prolonged in the early stage, reflecting progression of is chemic edema. (Abstract Truncated)

Shinguards effective in preventing lower leg injuries in football: Population-based trend analyses over 25 years.

Science.gov (United States)

Vriend, Ingrid; Valkenberg, Huib; Schoots, Wim; Goudswaard, Gert Jan; van der Meulen, Wout J; Backx, Frank J G

2015-09-01

The majority of football injuries are caused by trauma to the lower extremities. Shinguards are considered an important measure in preventing lower leg impact abrasions, contusions and fractures. Given these benefits, Fédération Internationale de Football Association introduced the shinguard law in 1990, which made wearing shinguards during matches mandatory. This study evaluated the effect of the introduction of the shinguard law for amateur players in the Netherlands in the 1999/2000-football season on the incidence of lower leg injuries. Time trend analyses on injury data covering 25 years of continuous registration (1986-2010). Data were retrieved from a system that records all emergency department treatments in a random, representative sample of Dutch hospitals. All injuries sustained in football by patients aged 6-65 years were included, except for injuries of the Achilles tendon and Weber fractures. Time trends were analysed with multiple regression analyses; a model was fitted consisting of multiple straight lines, each representing a 5-year period. Patients were predominantly males (92%) and treated for fractures (48%) or abrasions/contusions (52%) to the lower leg. The incidence of lower leg football injuries decreased significantly following the introduction of the shinguard law (1996-2000: -20%; 2001-2005: -25%), whereas the incidence of all other football injuries did not. This effect was more prominent at weekends/match days. No gender differences were found. The results significantly show a preventive effect of the shinguard law underlining the relevance of rule changes as a preventive measure and wearing shinguards during both matches and training sessions. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Plantar talar head contusions and osteochondral fractures: associated findings on ankle MRI and proposed mechanism of injury

Energy Technology Data Exchange (ETDEWEB)

Gorbachova, Tetyana; Wang, Peter S.; Hu, Bing [Einstein Medical Center Philadelphia, Department of Radiology, Philadelphia, PA (United States); Horrow, Jay C. [Drexel University, Department of Anesthesiology and Perioperative Medicine, Philadelphia, PA (United States)

2016-06-15

To evaluate the significance of plantar talar head injury (PTHI) in predicting osseous and soft tissue injuries on ankle MRI. The IRB approved this HIPAA-compliant retrospective study. The study group consisted of 41 ankle MRIs with PTHI that occurred at our institution over a 5 1/2 year period. Eighty MRIs with bone injuries in other locations matched for age, time interval since injury, and gender formed a control group. Injuries to the following structures were recorded: medial malleolus, lateral malleolus/distal fibula, posterior malleolus, talus, calcaneus, navicular, cuboid, lateral, medial and syndesmotic ligaments, spring ligament complex, and extensor digitorum brevis (EDB) muscle. Twenty separate logistic regressions determined which injuries PTHI predicted, using the Holm procedure to control for family-wise alpha at 0.05. PTHI strongly predicted the occurrence of injuries involving the anterior process of the calcaneus [24 % of cases, odds ratio (OR) 12.66], plantar components of the spring ligament (27 %, OR 9.43), calcaneal origin of the EDB and attachment of the dorsolateral calcaneocuboid ligament (22 %, OR 7.22), cuboid (51 %, OR 6.58), EDB (27 %, OR 5.49), anteromedial talus (66 %, OR 4.78), and posteromedial talus (49 %, OR 4.48). PTHI strongly predicted lack of occurrence of syndesmotic ligament injury (OR 19.6). The PTHI group had a high incidence of lateral ligamentous injury (78 %), but not significantly different from the control group (53 %). PTHI is strongly associated with injury involving the transverse tarsal joint complex. We hypothesize it results from talo-cuboid and/or talo-calcaneal impaction from a supination injury of the foot and ankle. (orig.)

Combination of Radiation and Burn Injury Alters FDG Uptake in Mice

Science.gov (United States)

Carter, Edward A.; Winter, David; Tolman, Crystal; Paul, Kasie; Hamrahi, Victoria; Tompkins, Ronald; Fischman, Alan J.

2012-01-01

Radiation exposure and burn injury have both been shown to alter glucose utilization in vivo. The present study was designed to study the effect of burn injury combined with radiation exposure, on glucose metabolism in mice using [18F] Fluorodeoxyglucose (18FDG). Groups of male mice weighing approximately 30g were studied. Group 1 was irradiated with a 137Cs source (9 Gy). Group 2 received full thickness burn injury on 25% total body surface area followed by resuscitated with saline (2mL, IP). Group 3 received radiation followed 10 minutes later by burn injury. Group 4 were sham treated controls. After treatment, the mice were fasted for 23 hours and then injected (IV) with 50 µCi of 18FDG. One hour post injection, the mice were sacrificed and biodistribution was measured. Positive blood cultures were observed in all groups of animals compared to the shams. Increased mortality was observed after 6 days in the burn plus radiated group as compared to the other groups. Radiation and burn treatments separately or in combination produced major changes in 18FDG uptake by many tissues. In the heart, brown adipose tissue (BAT) and spleen, radiation plus burn produced a much greater increase (p<0.0001) in 18FDG accumulation than either treatment separately. All three treatments produced moderate decreases in 18FDG accumulation (p<0.01) in the brain and gonads. Burn injury, but not irradiation, increased 18FDG accumulation in skeletal muscle; however the combination of burn plus radiation decreased 18FDG accumulation in skeletal muscle. This model may be useful for understanding the effects of burns + irradiation injury on glucose metabolism and in developing treatments for victims of injuries produced by the combination of burn plus irradiation. PMID:23143615

Herbicide injury induces DNA methylome alterations in Arabidopsis

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Gunjune Kim

2017-07-01

Full Text Available The emergence of herbicide-resistant weeds is a major threat facing modern agriculture. Over 470 weedy-plant populations have developed resistance to herbicides. Traditional evolutionary mechanisms are not always sufficient to explain the rapidity with which certain weed populations adapt in response to herbicide exposure. Stress-induced epigenetic changes, such as alterations in DNA methylation, are potential additional adaptive mechanisms for herbicide resistance. We performed methylC sequencing of Arabidopsis thaliana leaves that developed after either mock treatment or two different sub-lethal doses of the herbicide glyphosate, the most-used herbicide in the history of agriculture. The herbicide injury resulted in 9,205 differentially methylated regions (DMRs across the genome. In total, 5,914 of these DMRs were induced in a dose-dependent manner, wherein the methylation levels were positively correlated to the severity of the herbicide injury, suggesting that plants can modulate the magnitude of methylation changes based on the severity of the stress. Of the 3,680 genes associated with glyphosate-induced DMRs, only 7% were also implicated in methylation changes following biotic or salinity stress. These results demonstrate that plants respond to herbicide stress through changes in methylation patterns that are, in general, dose-sensitive and, at least partially, stress-specific.

Neurogenic stunned myocardium following hemorrhagic cerebral contusion

International Nuclear Information System (INIS)

Deleu, D.; Miyares, F.; Kettern, M.; Kumar, S.; Hassens, Y.; Salim, K.

2007-01-01

Neurogenic stunned myocardium NSM is a well-known complication of subarachnoidal hemorrhage, but has been reported rarely in association with other central nervous system disorders. A case of NSM is described in a patient with hemorrhagic brain contusion associated with cerebral edema. An 18-year-old man was admitted with severe cranial trauma following a car roll-over. Six days after admission, he developed findings suggestive for NSM. The troponin T and creatine kinase-MB level were elevated and echocardiogram showed apical and inferoposterior hypokinesis and diffuse left ventricular akinesis with severely reduced ejection fraction 18%. Invasive measurements confirmed low cardiac output. His cardiac function resolved completely within 6 days after decompressive craniotomy. This case supports the presumed unifying role of the increased intracranial pressure, probably triggering a vigorous sympathetic outflow hyperactivity leading to NSM. (author)

Thoracic hyperextension injury with complete “bony disruption” of the thoracic cage: Case report of a potentially life-threatening injury

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Bailey James

2012-05-01

Full Text Available Abstract Background Severe chest wall injuries are potentially life-threatening injuries which require a standardized multidisciplinary management strategy for prevention of posttraumatic complications and adverse outcome. Case presentation We report the successful management of a 55-year old man who sustained a complete “bony disruption” of the thoracic cage secondary to an “all-terrain vehicle” roll-over accident. The injury pattern consisted of a bilateral “flail chest” with serial segmental rib fractures, bilateral hemo-pneumothoraces and pulmonary contusions, bilateral midshaft clavicle fractures, a displaced transverse sternum fracture with significant diastasis, and an unstable T9 hyperextension injury. After initial life-saving procedures, the chest wall injuries were sequentially stabilized by surgical fixation of bilateral clavicle fractures, locked plating of the displaced sternal fracture, and a two-level anterior spine fixation of the T9 hyperextension injury. The patient had an excellent radiological and physiological outcome at 6 months post injury. Conclusion Severe chest wall trauma with a complete “bony disruption” of the thoracic cage represents a rare, but detrimental injury pattern. Multidisciplinary management with a staged timing for addressing each of the critical injuries, represents the ideal approach for an excellent long-term outcome.

Local injection of Lenti-Olig2 at lesion site promotes functional recovery of spinal cord injury in rats.

Science.gov (United States)

Tan, Bo-Tao; Jiang, Long; Liu, Li; Yin, Ying; Luo, Ze-Ru-Xin; Long, Zai-Yun; Li, Sen; Yu, Le-Hua; Wu, Ya-Min; Liu, Yuan

2017-06-01

Olig2 is one of the most critical factors during CNS development, which belongs to b-HLH transcription factor family. Previous reports have shown that Olig2 regulates the remyelination processes in CNS demyelination diseases models. However, the role of Olig2 in contusion spinal cord injury (SCI) and the possible therapeutic effects remain obscure. This study aims to investigate the effects of overexpression Olig2 by lentivirus on adult spinal cord injury rats. Lenti-Olig2 expression and control Lenti-eGFP vectors were prepared, and virus in a total of 5 μL (10 8 TU/mL) was locally injected into the injured spinal cord 1.5 mm rostral and caudal near the epicenter. Immunostaining, Western blot, electron microscopy, and CatWalk analyzes were employed to investigate the effects of Olig2 on spinal cord tissue repair and functional recovery. Injection of Lenti-Olig2 significantly increased the number of oligodendrocytes lineage cells and enhanced myelination after SCI. More importantly, the introduction of Olig2 greatly improved hindlimb locomotor performances. Other oligodendrocyte-related transcription factors, which were downregulated or upregulated after injury, were reversed by Olig2 induction. Our findings provided the evidence that overexpression Olig2 promotes myelination and locomotor recovery of contusion SCI, which gives us more understanding of Olig2 on spinal cord injury treatment. © 2017 John Wiley & Sons Ltd.

[An overview of snow-boarding injuries].

Science.gov (United States)

Biasca, N; Battaglia, H; Simmen, H P; Disler, P; Trentz, O

1995-01-01

Snowboarding is increasing dramatically in popularity in Switzerland as well as other countries. Work aimed at improving the design of the boards and of the boots and bindings has also increased rapidly during recent years. Most injured snowboarders are fit young men and boys who describe themselves as beginners and have had a minimal amount of instruction at an officially approved training centre. Appropriate snowboard training has mostly been quite inadequate, and protective devices (e.g. waterproofed support gloves). The anatomical distribution and the types of injuries sustained in snowboarding differ from those in alpine skiing. The wrist (and forearm) and the ankle are the most frequent locations of injuries (23%) as against the knee and thumb in alpine skiing. Sprains and strains were the most frequent types of injuries (46%), followed by fractures (28%) and contusions (13.5%). The snowboard injury rate was higher than in alpine skiing (1.7-8/1000 snowboard days versus 2-4/1000 ski days). Falling forward on the slope was the major mechanism of injury (80%), and torsion the next most frequent (20%). Snowboarding injuries were sustained most often on ice and hardpacked snow, compared with soft powder snow for alpine skiing injuries. Appropriate preseason conditioning, snowboarding lessons from a certified instructor, appropriate selection of rigorously tested equipment and use of protective devices are the main steps that must be taken to prevent injuries.

Early endocrine alterations reflect prolonged stress and relate to one year functional outcome in patients with severe brain injury

DEFF Research Database (Denmark)

Marina, Djordje; Klose, Marianne; Nordenbo, Annette

2015-01-01

OBJECTIVE: Severe brain injury poses a risk of developing acute and chronic hypopituitarism. Pituitary hormone alterations developed in the early recovery phase after brain injury may have implications for long-term functional recovery. The objective was to assess the pattern and prevalence...

Hyperextension injuries of the knee. Do patterns of bone bruising predict soft tissue injury?

Energy Technology Data Exchange (ETDEWEB)

Ali, A.M.; Gibbons, C.E.R. [Chelsea and Westminster Hospital, Department of Orthopaedic Surgery, London (United Kingdom); Pillai, J.K.; Roberton, B.J. [Chelsea and Westminster Hospital, Department of Radiology, London (United Kingdom); Gulati, V. [Homerton University Hospital, Department of Orthopaedic Surgery, London (United Kingdom)

2018-02-15

To establish whether patterns of soft tissue injury following knee hyperextension are associated with post-traumatic 'bone bruise' distribution. Patients with a knee MRI within one year of hyperextension injury were identified at our institution over a 7 year period. MRIs, plain radiographs and clinical details of these patients were reviewed. Twenty-five patients were identified (median time from injury to MRI = 24 days). The most common sites of bone bruising were the anteromedial tibial plateau (48%) and anterolateral tibial plateau (44%). There were high rates of injury to the posterior capsule (52%), ACL (40%) and PCL (40%) but lower rates of injury to the menisci (20%), medial and lateral collateral ligaments (16%) and posterolateral corner (16%). Anterior tibial plateau oedema and rupture of the posterior capsule predicted cruciate ligament injury [OR = 10.5 (p = 0.02) and 24.0 (p = 0.001) respectively]. Whilst anterolateral tibial plateau oedema strongly predicted PCL injury [OR = 26.0, p = 0.003], ACL injury was associated with a variable pattern of bone bruising. Meniscal injury was unrelated to the extent or pattern of bone bruising. 5 out of 8 patients with a 'double sulcus' on the lateral radiograph had ACL injury. The presence of a double sulcus showed significant association with anteromedial kissing contusions (OR = 7.8, p = 0.03). Following knee hyperextension, bone bruising patterns may be associated with cruciate ligament injury. Other structures are injured less frequently and have weaker associations with bone bruise distribution. The double sulcus sign is a radiographic marker that confers a high probability of ACL injury. (orig.)

Australian snowboard injury data base study. A four-year prospective study.

Science.gov (United States)

Bladin, C; Giddings, P; Robinson, M

1993-01-01

Information on the rate and spectrum of snowboarding injuries is limited. This 4-year prospective study at 3 major Australian ski resorts assesses incidence and patterns of snowboarding injuries, particularly in relation to skill level and footwear. Ski injury data were collected for the same period. In a predominantly male study population (men:women, 3:1), 276 snowboarding injuries were reported; 58% occurred in novices. Fifty-seven percent of injuries were in the lower limbs, 30% in the upper limbs. The most common injuries were sprains (53%), fractures (24%), and contusions (12%). Comparing skiers' versus snowboarders' injuries, snowboarders had 2.4 times as many fractures, particularly to the upper limbs (21% versus 35% of upper limb injuries), fewer knee injuries (23% versus 44% of lower limb injuries), but more ankle injuries (23% versus 6% of lower limb injuries). Ankle injuries were more common with soft-shell boots, worn most by intermediate and advanced riders. Knee injuries and distal tibial fractures were more common with hard-shell boots, worn most by novices. Overall, novices had more upper limb fractures and knee injuries; intermediate and advanced riders had more ankle injuries. Falls were the principal mode of injury. To prevent injury, beginners should use "hybrid" or soft-shell boots and take lessons.

Incidence and MRI characterization of the spectrum of posterolateral corner injuries occurring in association with ACL rupture

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Frois Temponi, Eduardo [Hospital Madre Teresa, Belo Horizonte, Minas Gerais (Brazil); Honorio de Carvalho, Lucio Jr. [Hospital Madre Teresa, Belo Horizonte, Minas Gerais (Brazil); Universidade Federal de Minas Gerais, Departamento do Aparelho Locomotor, Faculdade de Medicina, Belo Horizonte, Minas Gerais (Brazil); Saithna, Adnan [Southport and Ormskirk Hospitals, Southport (United Kingdom); University of Liverpool, Department of Clinical Engineering, Liverpool (United Kingdom); Thaunat, Mathieu; Sonnery-Cottet, Bertrand [Centre Orthopedic Santy, FIFA Medical Center of Excellence, Ramsay-Generale de Sante, Hopital Prive Jean Mermoz, Lyon (France)

2017-08-15

To determine the incidence and MRI characteristics of the spectrum of posterolateral corner (PLC) injuries occurring in association with anterior cruciate ligament (ACL) rupture. We carried out a level IV, retrospective case series study. All patients clinically diagnosed with an ACL rupture between July 2015 and June 2016 who underwent MRI of the knee were included in the study. In addition to standard MRI knee reporting, emphasis was placed on identifying injury to the PLC and a description of involvement of these structures by two musculoskeletal radiologists. Association with PLC involvement was sought with concomitant injuries using correlation analysis and logistic regression. One hundred sixty-two patients with MRI following ACL rupture were evaluated. Thirty-two patients (19.7%) had an injury to at least one structure of the PLC, including the inferior popliteomeniscal fascicle (n = 28), arcuate ligament (n = 20), popliteus tendon (n = 20), superior popliteomeniscal fascicle (n = 18), lateral collateral ligament (n = 8), popliteofibular ligament (n = 7), biceps tendon (n = 4), iliotibial band (n = 3), and fabellofibular ligament (n = 1). Seventy-five percent of all patients with combined ACL and PLC injuries had bone contusions involving the lateral compartment of the knee. The presence of these contusions strongly correlated with superior popliteomeniscal fascicle lesions (p < 0.05). There was no correlation between injuries to other structures of the PLC and other intra-articular lesions. Missed injuries of the PLC lead to considerable morbidity. The relevance of this study is to highlight that these injuries occur more frequently than previously described and that an appropriate index of suspicion, clinical examination, and MRI are all required to reduce the risk of missed diagnoses. The results of this study support previous suggestions that the rate of concomitant PLC injury in the ACL-deficient knee is under-reported. The rate of combined injuries in

Spatio-temporal progression of grey and white matter damage following contusion injury in rat spinal cord.

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C Joakim Ek

Full Text Available Cellular mechanisms of secondary damage progression following spinal cord injury remain unclear. We have studied the extent of tissue damage from 15 min to 10 weeks after injury using morphological and biochemical estimates of lesion volume and surviving grey and white matter. This has been achieved by semi-quantitative immunocytochemical methods for a range of cellular markers, quantitative counts of white matter axonal profiles in semi-thin sections and semi-quantitative Western blot analysis, together with behavioural tests (BBB scores, ledged beam, random rung horizontal ladder and DigiGait analysis. We have developed a new computer-controlled electronic impactor based on a linear motor that allows specification of the precise nature, extent and timing of the impact. Initial (15 min lesion volumes showed very low variance (1.92+/-0.23 mm3, mean+/-SD, n=5. Although substantial tissue clearance continued for weeks after injury, loss of grey matter was rapid and complete by 24 hours, whereas loss of white matter extended up to one week. No change was found between one and 10 weeks after injury for almost all morphological and biochemical estimates of lesion size or behavioural methods. These results suggest that previously reported apparent ongoing injury progression is likely to be due, to a large extent, to clearance of tissue damaged by the primary impact rather than continuing cell death. The low variance of the impactor and the comprehensive assessment methods described in this paper provide an improved basis on which the effects of potential treatment regimes for spinal cord injury can be assessed.

From the roots of rhinology: the reconstruction of nasal injuries by Hippocrates.

Science.gov (United States)

Lascaratos, John G; Segas, John V; Trompoukis, Constantinos C; Assimakopoulos, Dimitrios A

2003-02-01

The goal of this report is to describe the therapeutic methods and surgical techniques used by Hippocrates (5th century BC) in the treatment of nasal injuries. We studied the original Greek texts of the (generally considered genuine) Hippocratic book Mochlicon and, especially, the analytical On Joints. We identified the treatments and techniques applied to the restoration of injured noses. We found that Hippocrates classified nasal injuries, from simple contusions of soft tissues to complicated fractures. Hippocrates provided detailed instructions for each case, from poultice application and bandaging to reconstruction and reshaping of the nasal bones in cases of fractures and deviation. Hippocrates' texts reflect the interest of the classical period in nasal injuries, a common enough accident in athletics. Hippocratic conservative and surgical management for each form of injury was adopted by later physicians and influenced European medicine.

Effects of enriched housing on functional recovery after spinal cord contusive injury in the adult rat

NARCIS (Netherlands)

Gispen, W.H.; Lankhorst, A.J.; Laak, M.P. ter; Laar, T.J. van

2001-01-01

To date, most research performed in the area of spinal cord injury focuses on treatments designed to either prevent spreading lesion (secondary injury) or to enhance outgrowth of long descending and ascending fiber tracts around or through the lesion. In the last decade, however, several authors

Rib fractures in blunt chest trauma - associated thoracic injuries

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Iv. Dimitrov

2017-09-01

Full Text Available PURPOSE. The aim of our retrospective study was to analyze the patterns of associated thoracic injuries in patients underwent blunt chest trauma and rib fractures. METHODS. The study included 212 patients with rib fractures due to blunt thoracic trauma. The mechanism of trauma, the type of rib fracture and the type of associated injuries were analyzed. RESULTS. The patients were divided in two groups according to the number of fractured ribs-group I included the patients with up to two fractured ribs (72 patients-33,9%, and group II – with ≥3 fractured ribs (140 patients-66,1%. Associated chest injuries were present in 36 of the patients from group I (50%, and in 133 patients from group II (95%. Pulmonary contusion was the most common intrathoracicinjurie-65,6% of the cases. The mean hospital stay was 8, 7 days. The lethality rate was 16,9% -all of them due to the associated chest injuries. CONCLUSIONS. The mortality related to rib fractures is affected by the associated thoracic injuries, the advanced age, and the number of fractured ribs.

Unusual presentation of firework injury causing intraoral burns

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Patel Chintan

2005-01-01

Full Text Available Fireworks are commonly used in celebrate festive occasions. We present a case of an unusual presentation of intraoral firework injury, which is a very rare case. A fifteen year old boy kept four explosive papercaps wrapped in a small polythene bags in between his left molars and crushed them. This resulted in a contused lacerated wound over the left buccal mucosa. Patient was treated conservatively with maintenance of intraoral hygiene, antibiotics, proteolytic enzymes and analgesics. It took 18 days for complete healing of the wound.

Neurologic Outcome of Laminoplasty for Acute Traumatic Spinal Cord Injury without Instability

OpenAIRE

Lee, Hwa Joong; Kim, Hwan Soo; Nam, Kyoung Hyup; Han, In Ho; Cho, Won Ho; Choi, Byung Kwan

2013-01-01

Objective The purpose of this study is to evaluate the efficacy of laminoplasty in the treatment of spinal cord injury (SCI) without instability. Methods 79 patients with SCI without instability who underwent surgical treatment in our institute between January 2005 and September 2012 were retrospectively reviewed. Twenty nine patients fulfilled the inclusion criteria as follows: SCI without instability, spinal cord contusion in MRI, cervical stenosis more than 20%, follow up at least 6 months...

Trampoline-related injuries.

Science.gov (United States)

Larson, B J; Davis, J W

1995-08-01

Two hundred and seventeen patients who had sustained an injury during the recreational use of a trampoline were managed in the emergency room of Logan Regional Hospital in Logan, Utah, from January 1991 through December 1992. We retrospectively reviewed the charts and radiographs of these patients to categorize the injuries. Additional details regarding the injuries of seventy-two patients (33 per cent) were obtained by means of a telephone interview with use of a questionnaire. The injuries occurred from February through November, with the peak incidence in July. The patients were eighteen months to forty-five years old (average, ten years old); ninety-four patients (43 per cent) were five to nine years old. Eighty-four patients (39 per cent) sustained a fracture; fifty-four (25 per cent), a sprain or strain; forty-five (21 per cent), a laceration; and thirty-four (16 per cent), a contusion. Fifty-seven injuries (26 per cent) involved the elbow or forearm; forty-six (21 per cent), the head or neck; forty (18 per cent), the ankle or foot; thirty-three (15 per cent), the knee or leg; nineteen (9 per cent), the trunk or back; thirteen (6 per cent), the shoulder or arm; and nine (4 per cent), the wrist or hand. Thirteen patients (6 per cent) had a back injury, but none of them had a permanent neurological deficit. One patient who had an ocular injury was transferred to a tertiary care center. One hundred and fifty-six patients (72 per cent) were evaluated radiographically, fifteen (7 per cent) were admitted to the hospital, and thirteen (6 per cent) had an operation.(ABSTRACT TRUNCATED AT 250 WORDS)

The National Basketball Association eye injury study.

Science.gov (United States)

Zagelbaum, B M; Starkey, C; Hersh, P S; Donnenfeld, E D; Perry, H D; Jeffers, J B

1995-06-01

To investigate the epidemiology of eye injuries sustained by professional basketball players in the National Basketball Association (NBA). A prospective study involving all NBA athletes who sustained eye injuries between February 1, 1992, and June 20, 1993, was conducted. Twenty-seven NBA team athletic trainers, physicians, and ophthalmologists were provided data forms to complete for any player examined for an eye injury. Practice and game exposures during the preseason, regular season, playoffs, and championships were included. Of the 1092 injuries sustained by NBA players during the 17-month period, 59 (5.4%) involved the eye and adnexa. Eighteen (30.5%) of the injuries occurred while the player was in the act of rebounding, and 16 (27.1%) while the player was on offense. The most common diagnoses included 30 abrasions or lacerations to the eyelid (50.9%), 17 contusions (edema and/or ecchymosis) to the eyelid or periorbital region (28.8%), and seven corneal abrasions (11.9%). There were three orbital fractures (5.1%). Most injuries were caused by fingers (35.6%) or elbows (28.8%). Nine players (15.3%) missed subsequent games because of their injury. Fifty-seven players (96.6%) were not wearing protective eyewear at the time of injury. The incidence of eye injuries in NBA players during the 17-month period was 1.44 per 1000 game exposures. Frequent physical contact in professional basketball players leaves them at great risk for sustaining eye injuries. To prevent these injuries, protective eyewear is recommended.

[Severe Eyeball and Facial Skeletal Injuries Caused by Firefighting Sport].

Science.gov (United States)

Rusňák, Š; Maranová, Z; Kasl, Z; Hecová, L; Voigt, E; Raiskup, F

2017-07-01

The aim of this work is to draw attention to possible injuries of the eye and the facial skeleton caused by firefighting sport. There was a group of 9 patients presented who were treated from 2006 to 2015 in the Department of Ophthalmology at the University Hospital in Pilsen and diagnosed with severe eyeball contusion after being hit by a jet of water and/or a water pipe. Three cases are presented in detail. Georg Thieme Verlag KG Stuttgart · New York.

Altered caudate connectivity is associated with executive dysfunction after traumatic brain injury

Science.gov (United States)

De Simoni, Sara; Jenkins, Peter O; Bourke, Niall J; Fleminger, Jessica J; Jolly, Amy E; Patel, Maneesh C; Leech, Robert; Sharp, David J

2018-01-01

measures of executive dysfunction. We show for the first time that altered subcortical connectivity is associated with large-scale network disruption in traumatic brain injury and that this disruption is related to the cognitive impairments seen in these patients. PMID:29186356

Ubiquinol treatment for TBI in male rats: Effects on mitochondrial integrity, injury severity, and neurometabolism.

Science.gov (United States)

Pierce, Janet D; Gupte, Raeesa; Thimmesch, Amanda; Shen, Qiuhua; Hiebert, John B; Brooks, William M; Clancy, Richard L; Diaz, Francisco J; Harris, Janna L

2018-06-01

Following traumatic brain injury (TBI), there is significant secondary damage to cerebral tissue from increased free radicals and impaired mitochondrial function. This imbalance between reactive oxygen species (ROS) production and the effectiveness of cellular antioxidant defenses is termed oxidative stress. Often there are insufficient antioxidants to scavenge ROS, leading to alterations in cerebral structure and function. Attenuating oxidative stress following a TBI by administering an antioxidant may decrease secondary brain injury, and currently many drugs and supplements are being investigated. We explored an over-the-counter supplement called ubiquinol (reduced form of coenzyme Q10), a potent antioxidant naturally produced in brain mitochondria. We administered intra-arterial ubiquinol to rats to determine if it would reduce mitochondrial damage, apoptosis, and severity of a contusive TBI. Adult male F344 rats were randomly assigned to one of three groups: (1) Saline-TBI, (2) ubiquinol 30 minutes before TBI (UB-PreTBI), or (3) ubiquinol 30 minutes after TBI (UB-PostTBI). We found when ubiquinol was administered before or after TBI, rats had an acute reduction in brain mitochondrial damage, apoptosis, and two serum biomarkers of TBI severity, glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase-L1 (UCH-L1). However, in vivo neurometabolic assessment with proton magnetic resonance spectroscopy did not show attenuated injury-induced changes. These findings are the first to show that ubiquinol preserves mitochondria and reduces cellular injury severity after TBI, and support further study of ubiquinol as a promising adjunct therapy for TBI. © 2018 Wiley Periodicals, Inc.

Human hepatocyte growth factor promotes functional recovery in primates after spinal cord injury.

Science.gov (United States)

Kitamura, Kazuya; Fujiyoshi, Kanehiro; Yamane, Jun-Ichi; Toyota, Fumika; Hikishima, Keigo; Nomura, Tatsuji; Funakoshi, Hiroshi; Nakamura, Toshikazu; Aoki, Masashi; Toyama, Yoshiaki; Okano, Hideyuki; Nakamura, Masaya

2011-01-01

Many therapeutic interventions for spinal cord injury (SCI) using neurotrophic factors have focused on reducing the area damaged by secondary, post-injury degeneration, to promote functional recovery. Hepatocyte growth factor (HGF), which is a potent mitogen for mature hepatocytes and a mediator of the inflammatory responses to tissue injury, was recently highlighted as a potent neurotrophic factor in the central nervous system. We previously reported that introducing exogenous HGF into the injured rodent spinal cord using a herpes simplex virus-1 vector significantly reduces the area of damaged tissue and promotes functional recovery. However, that study did not examine the therapeutic effects of administering HGF after injury, which is the most critical issue for clinical application. To translate this strategy to human treatment, we induced a contusive cervical SCI in the common marmoset, a primate, and then administered recombinant human HGF (rhHGF) intrathecally. Motor function was assessed using an original open field scoring system focusing on manual function, including reach-and-grasp performance and hand placement in walking. The intrathecal rhHGF preserved the corticospinal fibers and myelinated areas, thereby promoting functional recovery. In vivo magnetic resonance imaging showed significant preservation of the intact spinal cord parenchyma. rhHGF-treatment did not give rise to an abnormal outgrowth of calcitonin gene related peptide positive fibers compared to the control group, indicating that this treatment did not induce or exacerbate allodynia. This is the first study to report the efficacy of rhHGF for treating SCI in non-human primates. In addition, this is the first presentation of a novel scale for assessing neurological motor performance in non-human primates after contusive cervical SCI.

Human hepatocyte growth factor promotes functional recovery in primates after spinal cord injury.

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Kazuya Kitamura

Full Text Available Many therapeutic interventions for spinal cord injury (SCI using neurotrophic factors have focused on reducing the area damaged by secondary, post-injury degeneration, to promote functional recovery. Hepatocyte growth factor (HGF, which is a potent mitogen for mature hepatocytes and a mediator of the inflammatory responses to tissue injury, was recently highlighted as a potent neurotrophic factor in the central nervous system. We previously reported that introducing exogenous HGF into the injured rodent spinal cord using a herpes simplex virus-1 vector significantly reduces the area of damaged tissue and promotes functional recovery. However, that study did not examine the therapeutic effects of administering HGF after injury, which is the most critical issue for clinical application. To translate this strategy to human treatment, we induced a contusive cervical SCI in the common marmoset, a primate, and then administered recombinant human HGF (rhHGF intrathecally. Motor function was assessed using an original open field scoring system focusing on manual function, including reach-and-grasp performance and hand placement in walking. The intrathecal rhHGF preserved the corticospinal fibers and myelinated areas, thereby promoting functional recovery. In vivo magnetic resonance imaging showed significant preservation of the intact spinal cord parenchyma. rhHGF-treatment did not give rise to an abnormal outgrowth of calcitonin gene related peptide positive fibers compared to the control group, indicating that this treatment did not induce or exacerbate allodynia. This is the first study to report the efficacy of rhHGF for treating SCI in non-human primates. In addition, this is the first presentation of a novel scale for assessing neurological motor performance in non-human primates after contusive cervical SCI.

[Frequently accidents and injury at school].

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Gautier Vargas, María; Martínez González, Vanesa

2011-01-01

During the time we have been in a private company that provide schools with medical care, we were surprised by the frequent and constant phone calls received to ask for our services. This fact made us take the decision to carry out a survey to find out the accidents and the most frequent injuries. According to the retrospective study we realized throughout two different academic courses in several schools in Cantabria, the 3.23% of the students have any accidents or injuries. We found out children between 11 and 15 have the highest accident rate, being 10.8 % higher when boys (rather than girls) are involved. The most common injuries are contusions 42.85%, followed by sprains 23.45%, being blows the reason in 42% of the cases, and surprisingly acts of aggression in 1%. It was also unexpected to learn that gyms, where children are taught in physical education, have the highest percent on accident rate. All these inquiries lead us to think that age, play and sports are determinant factors in the accidents happened in the school area.

Computed tomographic study of the complication of head injury

International Nuclear Information System (INIS)

Kojima, Tadashi; Waga, Shiro

1982-01-01

Computed tomography (CT) is quite effective in the diagnosis of traumatic intracranial hemorrhage and cerebral contusion. Two hundred and nine consecutive patients with head injury were admitted to the hospital and studied by CT in the year from 1977 to 1980. Fourty-sevenof 209 patients had the complications of head injury, including 6 patients with carotidcavernous fistula (CCF), 6 with traumatic aneurysm, 10 with pneumocephalus, 4 with intracranial foreign body, 15 with optic nerve injury, and 14 with other cranial nerve palsy. Five patients with CCF had abnormal finding on CT. Two traumatic aneurysms of the superficial temporal artery were visualized on CT after injection of contrast material, but all traumatic aneurysms of the carotid siphon were not seven on CT. CT in all 10 patients with pneumocephalus and in all 4 patients with intracranial foreign body was of diagnostic value: On CT in two patients even small air bubbles were seen in details. In the CT examination of 29 patients who presented with cranial nerve injury, we could not find out any abnormality on CT. We emphasize that CT is much less effective in the diagnosis of vascular complication of head injury and traumatic cranial nerve injury. (author)

Lung contusion and cavitation with exudative plural effusion following extracorporeal shock wave lithotripsy in an adult: a case report

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Nouri-Majalan Nader

2010-08-01

Full Text Available Abstract Introduction Among the complications of extracorporeal shock wave lithotripsy are perinephric bleeding and hypertension. Case presentation We describe the case of a 31-year-old Asian man with an unusual case of hemoptysis and lung contusion and cavitation with exudative plural effusion due to pulmonary trauma following false positioning of extracorporeal shock wave lithotripsy. Differential diagnoses included pneumonia and pulmonary emboli, but these diagnoses were ruled out by the uniformly negative results of a lung perfusion scan, Doppler ultrasound, and culture of bronchoalveolar lavage and plural effusion, and because our patient showed spontaneous improvement. Conclusions False positioning of extracorporeal shock wave lithotripsy can cause lung trauma presenting as pulmonary contusion and cavitation with plural effusion.

Recovered neuronal viability revealed by Iodine-123-iomazenil SPECT following traumatic brain injury

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Koizumi, Hiroyasu; Fujisawa, Hirosuke; Kurokawa, Tetsu; Suehiro, Eiichi; Iwanaga, Hideyuki; Nakagawara, Jyoji; Suzuki, Michiyasu

2010-01-01

We evaluated cortical damages following traumatic brain injury (TBI) in the acute phase with [123I] iomazenil (IMZ) single photon emission computed tomography (SPECT). In all, 12 patients with cerebral contusion following TBI were recruited. All patients underwent IMZ SPECT within 1 week after TBI. To investigate the changes in distribution of IMZ in the cortex in the chronic phase, after conventional treatment, patients underwent IMZ SPECT again. A decrease in the accumulation of radioligand...

Pre-competition habits and injuries in Taekwondo athletes

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Su Choung Young

2005-05-01

Full Text Available Abstract Background Over the past decade, there has been heightened interest in injury rates sustained by martial arts athletes, and more specifically, Taekwondo athletes. Despite this interest, there is a paucity of research on pre-competition habits and training of these athletes. The purpose of this pilot study was to assess training characteristics, competition preparation habits, and injury profiles of Taekwondo athletes. Methods A retrospective survey of Canadian male and female Taekwondo athletes competing in a national tournament was conducted. Competitors at a Canadian national level tournament were given a comprehensive survey prior to competition. Items on training characteristics, diet, and injuries sustained during training and competition were included. Questionnaires were distributed to 60 athletes. Results A response rate of 46.7% was achieved. Of those that responded, 54% dieted prior to competition, and 36% dieted and exercised pre-competition. Sixty-four percent of the athletes practised between 4–6 times per week, with 54% practicing 2 hours per session. Lower limb injuries were the most common (46.5%, followed by upper extremity (18%, back (10%, and head (3.6%. The majority of injuries consisted of sprains/strains (45%, followed by contusions, fractures, and concussions. More injuries occurred during training, including 59% of first injuries. Conclusion More research needs to be conducted to further illustrate the need for appropriate regulations on weight cycling and injury prevention.

Pre-competition habits and injuries in Taekwondo athletes

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Kazemi, Mohsen; Shearer, Heather; Su Choung, Young

2005-01-01

Background Over the past decade, there has been heightened interest in injury rates sustained by martial arts athletes, and more specifically, Taekwondo athletes. Despite this interest, there is a paucity of research on pre-competition habits and training of these athletes. The purpose of this pilot study was to assess training characteristics, competition preparation habits, and injury profiles of Taekwondo athletes. Methods A retrospective survey of Canadian male and female Taekwondo athletes competing in a national tournament was conducted. Competitors at a Canadian national level tournament were given a comprehensive survey prior to competition. Items on training characteristics, diet, and injuries sustained during training and competition were included. Questionnaires were distributed to 60 athletes. Results A response rate of 46.7% was achieved. Of those that responded, 54% dieted prior to competition, and 36% dieted and exercised pre-competition. Sixty-four percent of the athletes practised between 4–6 times per week, with 54% practicing 2 hours per session. Lower limb injuries were the most common (46.5%), followed by upper extremity (18%), back (10%), and head (3.6%). The majority of injuries consisted of sprains/strains (45%), followed by contusions, fractures, and concussions. More injuries occurred during training, including 59% of first injuries. Conclusion More research needs to be conducted to further illustrate the need for appropriate regulations on weight cycling and injury prevention. PMID:15921510

Surveillance of construction worker injuries through an urban emergency department.

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Hunting, K L; Nessel-Stephens, L; Sanford, S M; Shesser, R; Welch, L S

1994-03-01

To learn more about the causes of nonfatal construction worker injuries, and to identify injury cases for further work-site investigations or prevention programs, an emergency department-based surveillance program was established. Construction workers with work-related injuries or illnesses were identified by reviewing the medical records of all patients treated at the George Washington University Emergency Department between November 1, 1990 and November 31, 1992. Information regarding the worker, the injury, and the injury circumstances were abstracted from medical records. Information was obtained on 592 injured construction workers from numerous trades. Lacerations were the most commonly treated injuries among these workers, followed by strains and sprains, contusions, and eye injuries. Injuries were most commonly caused by sharp objects (n = 155, 26%), falls (n = 106, 18%), and falling objects (n = 70, 12%). Thirty-five percent of injuries were to the hands, wrists, or fingers. Among the twenty-eight injuries severe enough to require hospital admission, eighteen (64%) were caused by falls. Laborers and Hispanic workers were overrepresented among these severe cases. Emergency Department records were a useful surveillance tool for the initial identification and description of work-related injuries. Although E codes were not that useful for formulating prevention strategies, detailed review of injury circumstances from Emergency Department records was valuable and has helped to establish priorities for prevention activities.

Intraoperative contrast-enhanced ultrasonography for microcirculatory evaluation in rhesus monkey with spinal cord injury.

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Huang, Lin; Chen, Keng; Chen, Fu-Chao; Shen, Hui-Yong; Ye, Ji-Chao; Cai, Zhao-Peng; Lin, Xi

2017-06-20

This study tried to quantify spinal cord perfusion by using contrast-enhanced ultrasound (CEUS) in rhesus monkey models with acute spinal cord injury. Acute spinal cord perfusion after injury was detected by CEUS, coupling with conventional ultrasound (US) and Color Doppler US (CDFI). Time-intensity curves and perfusion parameters were obtained by autotracking contrast quantification (ACQ) software in the epicenter and adjacent regions of injury, respectively. Neurological and histological examinations were performed to confirm the severity of injury. US revealed spinal cords were hypoechoic and homogeneous, whereas dura maters, pia maters, and cerebral aqueducts were hyperechoic. After spinal cord contusion, the injured spinal cord was hyperechoic on US, and intramedullary vessels of adjacent region of injury were increased and dilated on CDFI. On CEUS hypoperfusion were found in the epicenter of injury, while hyperperfusion in its adjacent region. Quantitative analysis showed that peak intensity (PI) decreased in epicenters of injury but significantly increased in adjacent regions at all time points (p spinal cord injury in overall views and real-time.

Magnetic resonance imaging evaluation of traumatic muscle injuries

International Nuclear Information System (INIS)

Dias, Elisa Pompeu; Marchiori, Edson

2001-01-01

We evaluated 43 magnetic resonance scans of the leg or thigh of patients suffering from sports trauma. Strains were the most frequent lesions observed. These lesions presented iso- or hypointense signal on T1 and hyperintense signal on T2 images, and were classified according to the intensity of the injury of the fibers into grades 1, 2 and 3. The second most common lesions in these series were contusions that appeared iso- or hypointense on T1 and hyperintense on T2 images. Fibrosis was also observed as low signal lesions on T1 and T2 images. (author)

Altered caudate connectivity is associated with executive dysfunction after traumatic brain injury.

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De Simoni, Sara; Jenkins, Peter O; Bourke, Niall J; Fleminger, Jessica J; Hellyer, Peter J; Jolly, Amy E; Patel, Maneesh C; Cole, James H; Leech, Robert; Sharp, David J

2018-01-01

executive dysfunction. We show for the first time that altered subcortical connectivity is associated with large-scale network disruption in traumatic brain injury and that this disruption is related to the cognitive impairments seen in these patients. © The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain.

11.361 sports injuries in a 15-year survey of a Level I emergency trauma department reveal different severe injury types in the 6 most common team sports.

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Krutsch, Werner; Krutsch, Volker; Hilber, Franz; Pfeifer, Christian; Baumann, Florian; Weber, Johannes; Schmitz, Paul; Kerschbaum, Maximilian; Nerlich, Michael; Angele, Peter

2018-06-01

 Severe sports-related injuries are a common affliction treated in Level I trauma departments. Detailed knowledge on injury characteristics from different medical settings is essential to improve the development of injury prevention strategies in different team sports.  Team sport injuries were retrospectively analysed in a Level I trauma department registry over 15 years. Injury and treatment data were compared with regard to competition and training exposure. Injury data such as "time of visitation", "type of injury", "multiple injured body regions" and "immediate hospitalisation" helped to define the severity level of each team sports injury.  At the Level I trauma department, 11.361 sports-related injuries were seen over 15 years, of which 34.0 % were sustained during team sports. Soccer injuries were the most common injuries of all team sports (71.4 %). The lower extremity was the most affected body region overall, followed by the upper extremity. Head injuries were mainly seen in Ice hockey and American football and concussion additionally frequently in team handball. Slight injuries like sprains or contusions occurred most frequently in all team sports. In soccer and team handball, injuries sustained in competition were significantly more severe (p team sports, injury prevention strategies should address competitive as well as training situations, whichmay need different strategies. © Georg Thieme Verlag KG Stuttgart · New York.

Diagnosis and classification of pancreatic and duodenal injuries in emergency radiology.

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Linsenmaier, Ulrich; Wirth, Stefan; Reiser, Maximilian; Körner, Markus

2008-10-01

Pancreatic and duodenal injuries after blunt abdominal trauma are rare; however, delays in diagnosis and treatment can significantly increase morbidity and mortality. Multidetector computed tomography (CT) has a major role in early diagnosis of pancreatic and duodenal injuries. Detecting the often subtle signs of injury with whole-body CT can be difficult because this technique usually does not include a dedicated protocol for scanning the pancreas. Specific injury patterns in the pancreas and duodenum often have variable expression at early posttraumatic multidetector CT: They may be hardly visible, or there may be considerable exudate, hematomas, organ ruptures, or active bleeding. An accurate multidetector CT technique allows optimized detection of subtle abnormalities. In duodenal injuries, differentiation between a contusion of the duodenal wall or mural hematoma and a duodenal perforation is vital. In pancreatic injuries, determination of involvement of the pancreatic duct is essential. The latter conditions require immediate surgical intervention. Use of organ injury scales and a surgical classification adapted for multidetector CT enables classification of organ injuries for trauma scoring, treatment planning, and outcome control. In addition, multidetector CT reliably demonstrates potential complications of duodenal and pancreatic injuries, such as posttraumatic pancreatitis, pseudocysts, fistulas, exudates, and abscesses. (c) RSNA, 2008.

Shopping cart injuries, entrapment, and childhood fatality.

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Jensen, Lisbeth; Charlwood, Cheryl; Byard, Roger W

2008-09-01

Shopping carts may be associated with a variety of injuries, particularly in toddlers and young children. These usually relate to falls from carts or to tip-overs. Injuries that are sustained include hematomas/contusions, abrasions, lacerations, fractures, and fingertip amputations. Fatal episodes are uncommon and are usually due to blunt craniocerebral trauma from falls. A case involving a 19-month-old girl is reported who became entrapped when she inserted her head through the side frame of a cart that had been removed from a supermarket and left at her home address. Death was caused by neck compression. Although rare, the potential for lethal entrapment during unsupervised play means that the presence of stray shopping carts at private residences and in public places, including playgrounds and parks, is of concern. Strategies, such as coin deposits, should be encouraged to assist in the return of such carts to supermarkets.

MDCT Findings of Traumatic Adrenal Injury in Children

International Nuclear Information System (INIS)

Choi, Seung Joon; Kim, Jee Eun; Ryu, Il; Kim, Jin Joo; Choi, Hye Young

2011-01-01

We wanted to evaluate the MDCT findings and concomitant injuries of traumatic adrenal injury in children. Among 375 children who had undergone a MDCT scan for abdominal trauma during the recent five years at our institution, 27 children who had revealed adrenal injury on their CT scan were included in the study. We retrospectively evaluated the causes of the trauma, the patterns of adrenal injury, the associated CT findings and the concomitant injuries of the other organs in the abdomen. We identified 27 children (7.5%) (17 boys and 10 girls, mean age: 9.9 years, range: 2-18 years) with adrenal injury. The causes of adrenal injury were a traffic accident for 20 patients (74%), falls for four patients (15%) and blunt trauma for three patients (11%). The right adrenal gland was injured in 20 patients (74%), while the left adrenal gland was injured in three patients and bilateral involvement was noted in four patients. The patterns of adrenal injury were round or oval shaped hematoma in 23 lesions (74%), irregular hemorrhage with obliterating the gland in six lesions (19%) and active extravasation of contrast material from the adrenal region in two lesions (7%). Concomitant injuries were noted in 22 patients (81%), including 15 patients with liver laceration (56%), 11 patients with lung contusion (41%) and nine patients with renal injury (33%). The frequency of adrenal injury was 7.5%. The right adrenal gland was more frequently involved. Concomitant organ injury was noted 81% of the patients and the most frequently involved organ was the liver (56%)

Estimating Selected Disease and Non-Battle Injury Echelon 1 and Echelon 2 Outpatient Visits of U.S. Soldiers and Marines in an Operational Setting from Corresponding Echelon 3 (Hospitalizations) Admissions in the Same Theater of Operation

Science.gov (United States)

2000-06-01

musculoskeletal and soft -tissue complaints. Includes fractures.. sprains, lacerations, abrasions, contusions, dislocations, muscle pulls, or other acute...herpes, pelvic inflammatory disease, venereal warts/ chancres . It. DENTAL (DEN): Dental injury, disease, or condition requiring care by a dentist t

Central canal ependymal cells proliferate extensively in response to traumatic spinal cord injury but not demyelinating lesions.

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Steve Lacroix

Full Text Available The adult mammalian spinal cord has limited regenerative capacity in settings such as spinal cord injury (SCI and multiple sclerosis (MS. Recent studies have revealed that ependymal cells lining the central canal possess latent neural stem cell potential, undergoing proliferation and multi-lineage differentiation following experimental SCI. To determine whether reactive ependymal cells are a realistic endogenous cell population to target in order to promote spinal cord repair, we assessed the spatiotemporal dynamics of ependymal cell proliferation for up to 35 days in three models of spinal pathologies: contusion SCI using the Infinite Horizon impactor, focal demyelination by intraspinal injection of lysophosphatidylcholine (LPC, and autoimmune-mediated multi-focal demyelination using the active experimental autoimmune encephalomyelitis (EAE model of MS. Contusion SCI at the T9-10 thoracic level stimulated a robust, long-lasting and long-distance wave of ependymal proliferation that peaked at 3 days in the lesion segment, 14 days in the rostral segment, and was still detectable at the cervical level, where it peaked at 21 days. This proliferative wave was suppressed distal to the contusion. Unlike SCI, neither chemical- nor autoimmune-mediated demyelination triggered ependymal cell proliferation at any time point, despite the occurrence of demyelination (LPC and EAE, remyelination (LPC and significant locomotor defects (EAE. Thus, traumatic SCI induces widespread and enduring activation of reactive ependymal cells, identifying them as a robust cell population to target for therapeutic manipulation after contusion; conversely, neither demyelination, remyelination nor autoimmunity appears sufficient to trigger proliferation of quiescent ependymal cells in models of MS-like demyelinating diseases.

Pediatric injuries associated with fireplaces, United States, 2002-2007.

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Hammig, Bart J; Henry, Jean

2011-02-01

To examine injuries among pediatric patients treated in an emergency department (ED) related to contact with a fireplace. Data were obtained from the National Electronic Injury Surveillance System for the years 2002 through 2007. National estimates of ED visits for injuries associated with fireplaces were analyzed. Average annual rates were calculated, and logistic regression analyses were used to determine risk estimates for patient demographic characteristics related to ED visits for injuries associated with fireplaces. From 2002 through 2007, there were an estimated 8000 ED visits annually for injuries related to fireplaces in the United States, with an average annual rate of 18.8 ED visits per 100,000 children aged birth through 10 years. The most common injuries involved lacerations (66%), burns (10%), and contusions (10%). Most injuries occurred to the face (46%) or head (31%). Most patients (98%) were treated and released the same day. Results of logistic regression analyses revealed that children aged birth to 3 years (odds ratio, 12.2; 95% confidence interval, 9.1-16.5) and children aged 4 to 6 years (odds ratio, 4.8; 95% confidence interval, 3.5-6.5) were more likely present in an ED for a fireplace-related injury when compared with older children aged 7 to 10 years. Further research is warranted in the areas of etiology, injury prevention interventions, health communications, and surveillance to facilitate more effective injury prevention efforts.

Blunt renal trauma in children: healing of renal injuries and recommendations for imaging follow-up

International Nuclear Information System (INIS)

Abdalati, H.; Bulas, D.I.; Sivit, C.J.; Majd, M.; Rushton, H.G.; Eichelberger, M.R.

1994-01-01

Initial CT grading of renal injury was correlated with the frequency of complications and the time course of healing in 35 children. All renal contusions (grade 1, 8) and small parenchymal lacerations (grade 2, 8) healed without complications. All lacerations extending to the collecting system (grade 3, 9) resulted in mild to severe loss of renal function with progressive healing over 4 months. One of four segmental infarcts (grade 4 A), and five of six vascular pedicle injuries (grade 4 B) resulted in severe loss of renal function. Complications, including urinoma (2), sepsis (1), hydronephrosis (1), and persistent hypertension (2), were limited to grade 3 and 4 injuries. Our results suggest that mild renal injuries do not require follow-up imaging. Major renal lacerations and vascular pedicle injuries, however, often result in loss of renal function and should be followed up closely due to the risk of delayed complications. Follow-up examinations should continue for 3-4 months until healing is documented. (orig.)

Etiology and mechanisms of ulnar and median forearm nerve injuries

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Puzović Vladimir

2015-01-01

Full Text Available Bacgraund/Aim. Most often injuries of brachial plexus and its branches disable the injured from using their arms and/or hands. The aim of this study was to investigate the etiology and mechanisms of median and ulnar forearm nerves injuries. Methods. This retrospective cohort study included 99 patients surgically treated in the Clinic of Neurosurgery, Clinical Center of Serbia, from January 1st, 2000 to December 31st, 2010. All data are obtained from the patients' histories. Results. The majority of the injured patients were male, 81 (81.8%, while only 18 (18.2% were females, both mainly with nerve injuries of the distal forearm - 75 (75.6%. Two injury mechanisms were present, transection in 85 patients and traction and contusion in 14 of the patients. The most frequent etiological factor of nerve injuries was cutting, in 61 of the patients. Nerve injuries are often associated with other injuries. In the studied patients there were 22 vascular injuries, 33 muscle and tendon injuries and 20 bone fractures. Conclusion. The majority of those patients with peripheral nerve injuries are represented in the working age population, which is a major socioeconomic problem. In our study 66 out of 99 patients were between 17 and 40 years old, in the most productive age. The fact that the majority of patients had nerve injuries of the distal forearm and that they are operated within the first 6 months after injury, promises them good functional prognosis.

Nonparticipant injuries associated with skating activities.

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Knox, Christy L; Comstock, R Dawn

2006-03-01

Children are at risk for injury even if they are not active recreational participants. This study describes the epidemiology of pediatric nonparticipant skating-related injuries treated in hospital emergency departments in the United States from 1993 to 2003. Narratives of injuries identified by the US Consumer Product Safety Commission's National Electronic Injury Surveillance System consumer product codes as ice-skating, roller-skating, and in-line skating-related were reviewed. Fifty-eight children were treated for nonparticipant skating-related injuries in National Electronic Injury Surveillance System emergency departments. Mechanisms of injury included being stepped on (36.2%), dropped (34.5%), or kicked (12.1%) by skaters and collision with skaters (17.2%). The most common body regions injured were the lower extremities (41.4%), upper extremities (24.1%), and head (20.7%). Contusions/abrasions (32.8%), lacerations (20.7%), and fractures (19.0%) were the most common diagnoses. Children who were dropped sustained more head injuries than children injured by other mechanisms (relative risk [RR], 20.9; 95% confidence interval [CI], 2.9-150.5; P < 0.001) and were younger than those stepped on (RR, 1.5; 95% CI, 1.1-2.2; P = 0.02) or kicked (RR, 6.7; 95% CI, 1.1-40.9; P < 0.001). Children stepped on by skaters experienced more injuries to the extremities than children who were dropped by (RR, 3.3; 95% CI, 1.7-6.5; P < 0.001) or collided with skaters (RR, 1.7; 95% CI, 1.0-2.8; P < 0.01). Children are at risk for injury when they are around skaters. The risk of such injuries can be reduced if children are never carried by skaters, young children are closely supervised to avoid collisions, and skaters are cautioned against kicking or stepping on other children.

Clinical and magnetic resonance imaging correlation in acute spinal cord injury

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Ramon, S.; Dominguez, R.; Ramirez, L.; Garcia Fernandez, L. [University Hospital Vall d`Hebron, Barcelona (Spain)

1998-04-01

The aim of this study was to correlate traumatic spinal cord injury (SCI) patients`outcome with magnetic resonance imaging (MRI) performed within the first 15 days following trauma. We retrospectively analyzed 55 SCI patients. Early functional prognosis may be established on the basis of clinical presentation of SCI and associated MRI. Cord hemorrhage and transection are irreversible, while edema has a potential for neurological recovery. Cord contusion tends to be associated with an incomplete SCI, unlike the compression pattern, in which the prognosis depends on the degree of the initial neurological damage. (author)

Clinical and magnetic resonance imaging correlation in acute spinal cord injury

International Nuclear Information System (INIS)

Ramon, S.; Dominguez, R.; Ramirez, L.; Garcia Fernandez, L.

1998-01-01

The aim of this study was to correlate traumatic spinal cord injury (SCI) patients'outcome with magnetic resonance imaging (MRI) performed within the first 15 days following trauma. We retrospectively analyzed 55 SCI patients. Early functional prognosis may be established on the basis of clinical presentation of SCI and associated MRI. Cord hemorrhage and transection are irreversible, while edema has a potential for neurological recovery. Cord contusion tends to be associated with an incomplete SCI, unlike the compression pattern, in which the prognosis depends on the degree of the initial neurological damage. (author)

Topiramate as a neuroprotective agent in a rat model of spinal cord injury

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Firat Narin

2017-01-01

Full Text Available Topiramate (TPM is a widely used antiepileptic and antimigraine agent which has been shown to exert neuroprotective effects in various experimental traumatic brain injury and stroke models. However, its utility in spinal cord injury has not been studied extensively. Thus, we evaluated effects of TPM on secondary cellular injury mechanisms in an experimental rat model of traumatic spinal cord injury (SCI. After rat models of thoracic contusive SCI were established by free weight-drop method, TPM (40 mg/kg was given at 12-hour intervals for four times orally. Post TPM treatment, malondialdehyde and protein carbonyl levels were significantly reduced and reduced glutathione levels were increased, while immunoreactivity for endothelial nitric oxide synthase, inducible nitric oxide synthase, and apoptotic peptidase activating factor 1 was diminished in SCI rats. In addition, TPM treatment improved the functional recovery of SCI rats. This study suggests that administration of TPM exerts neuroprotective effects on SCI.

Clinical treatment of traumatic brain injury complicated by cranial nerve injury.

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Jin, Hai; Wang, Sumin; Hou, Lijun; Pan, Chengguang; Li, Bo; Wang, Hui; Yu, Mingkun; Lu, Yicheng

2010-09-01

To discuss the epidemiology, diagnosis and surgical treatment of cranial nerve injury following traumatic brain injury (TBI) for the sake of raising the clinical treatment of this special category of TBI. A retrospective analysis was made of 312 patients with cranial nerve injury among 3417 TBI patients, who were admitted for treatment in this hospital. A total of 312 patients (9.1%) involving either a single nerve or multiple nerves among the 12 pairs of cranial nerves were observed. The extent of nerve injury varied and involved the olfactory nerve (66 cases), optic nerve (78 cases), oculomotor nerve (56 cases), trochlear nerve (8 cases), trigeminal nerve (4 cases), abducent nerve (12 cases), facial nerve (48 cases), acoustic nerve (10 cases), glossopharyngeal nerve (8 cases), vagus nerve (6 cases), accessory nerve (10 cases) and hypoglossal nerve (6 cases). Imaging examination revealed skull fracture in 217 cases, complicated brain contusion in 232 cases, epidural haematoma in 194 cases, subarachnoid haemorrhage in 32 cases, nasal cerebrospinal fluid (CSF) leakage in 76 cases and ear CSF leakage in 8 cases. Of the 312 patients, 46 patients died; the mortality rate associated with low cranial nerve injury was as high as 73.3%. Among the 266 surviving patients, 199 patients received conservative therapy and 67 patients received surgical therapy; the curative rates among these two groups were 61.3% (122 patients) and 86.6% (58 patients), respectively. TBI-complicated cranial nerve injury is subject to a high incidence rate, a high mortality rate and a high disability rate. Our findings suggest that the chance of recovery may be increased in cases where injuries are amenable to surgical decompression. It is necessary to study all 12 pairs of cranial nerves systematically. Clinically, it is necessary to standardise surgical indications, operation timing, surgical approaches and methods for the treatment of TBI-complicated cranial nerve injury. 2010 Elsevier Ltd. All

Profile injuries and musculoskeletal abnormalities of elite wushu athletes

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Mohammad Reza Changizi

2017-09-01

Full Text Available The objective of this study was to investigate the profile of sports injuries and postural abnormalities of elite wushu athletes. Participants were recruited purposefully (n = 51, age 16.3 (4.9 years, height 165.4 (13.9 cm and weight 52.6 (14.7 kg and informed consent participated in the study. Injury report form (including type, anatomic site, etiology and mechanism of injury was used to record the damage. Posture was assesses using Grid Chart, flexible ruler, calipers and mirror box were performed. In order to analyze the data, descriptive and inferential statistical methods, chi-square was used. 166 injuries and 167 postural abnormalities were recorded. Injury type, anatomical location, and mechanism of injury and abnormalities in elite status was significantly different (P>0.05. 6.85 injuries per 1000 hours exposure and the risk of 8.91 injuries per 1000 athlete exposures was estimated. The most common types of injury were contusion (36.7%, hematoma (20.5% and abrasions (13.3% respectively. Based on the anatomic site of injury, lower extremities (47.6%, head and face (25.9%, upper extremities (13.9% and trunk (12.7% were injured mostly respectively. Opponent's Blow down technique (24.7%, previous injury (16.3%, lack of physical fitness (12.7% and fatigue (12% were in top priority. Receiving kicks (21%, Receiving punches (13.8% and throwing technique by opponent (12% were the most common mechanisms of injury. Flat foot (29.3%, uneven shoulders (25.7% and scoliosis (16.2% were the most common postural abnormalities.

Mitochondrial Optic Atrophy (OPA) 1 Processing Is Altered in Response to Neonatal Hypoxic-Ischemic Brain Injury

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Baburamani, Ana A.; Hurling, Chloe; Stolp, Helen; Sobotka, Kristina; Gressens, Pierre; Hagberg, Henrik; Thornton, Claire

2015-01-01

Perturbation of mitochondrial function and subsequent induction of cell death pathways are key hallmarks in neonatal hypoxic-ischemic (HI) injury, both in animal models and in term infants. Mitoprotective therapies therefore offer a new avenue for intervention for the babies who suffer life-long disabilities as a result of birth asphyxia. Here we show that after oxygen-glucose deprivation in primary neurons or in a mouse model of HI, mitochondrial protein homeostasis is altered, manifesting as a change in mitochondrial morphology and functional impairment. Furthermore we find that the mitochondrial fusion and cristae regulatory protein, OPA1, is aberrantly cleaved to shorter forms. OPA1 cleavage is normally regulated by a balanced action of the proteases Yme1L and Oma1. However, in primary neurons or after HI in vivo, protein expression of YmelL is also reduced, whereas no change is observed in Oma1 expression. Our data strongly suggest that alterations in mitochondria-shaping proteins are an early event in the pathogenesis of neonatal HI injury. PMID:26393574

Injury Risk Factors in a Small-Scale Gold Mining Community in Ghana's Upper East Region.

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Long, Rachel N; Sun, Kan; Neitzel, Richard L

2015-07-24

Occupational injury is one of many health concerns related to small-scale gold mining (ASGM), but few data exist on the subject, especially in sub-Saharan Africa. In 2011 and 2013, we examined accidents, injuries, and potential risk factors in a Ghanaian ASGM community. In 2011, 173 participants were surveyed on occupational history and health, and 22 of these were surveyed again in 2013. Injury rates were estimated at 45.5 and 38.5 injuries per 100 person-years in 2011 and in 2013, respectively; these rates far surpass those of industrialized mines in the U.S. and South Africa. Demographic and job characteristics generally were not predictive of injury risk, though there was a significant positive association with injury risk for males and smokers. Legs and knees were the most common body parts injured, and falling was the most common cause of injury. The most common type of injuries were cuts or lacerations, burns and scalds, and contusions and abrasions. Only two miners had ever received any occupational safety training, and PPE use was low. Our results suggest that injuries should be a priority area for occupational health research in ASGM.

Variation of Blunt Traumatic Injury with Age in Older Adults: Statewide Analysis 2011-14

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Emily Earl-Royal

2016-11-01

Full Text Available Introduction: Traumatic injury is a leading cause of death and disability in adults ≥ 65 years old, but there are few epidemiological studies addressing this issue. The aim of this study was to assess how characteristics of blunt traumatic injuries in adults ≥ 65 vary by age. Methods: Using data from the a single-state trauma registry, this retrospective cohort study examined injured patients ≥ 65 admitted to all Level I and Level II trauma centers in Pennsylvania between 2011 and 2014 (n=38,562. Patients were stratified by age into three subgroups (age 65-74; 75-84; ≥85. We compared demographics, injury, and system-level across groups. Results: We found significant increases in the proportion of female gender, (48.6% vs. 58.7% vs. 67.7%, white race (89.1% vs. 92.6% vs. 94.6%, and non-Hispanic ethnicity (97.5% vs. 98.6% vs. 99.4% across advancing age across age groups, respectively. As age increased, the proportion of falls (69.9% vs. 82.1% vs. 90.3%, in-hospital mortality (4.6% vs. 6.2% vs. 6.8%, and proportion of patients arriving to the hospital via ambulance also increased (73.6% vs. 75.8% vs. 81.1%, while median injury severity plateaued (9.0% all groups and the proportion of Level I trauma alerts (10.6% vs. 8.2% vs. 6.7% decreased. We found no trend between age and patient transfer status. The five most common diagnoses were vertebral fracture, rib fracture, head contusion, open head wound, and intracranial hemorrhage, with vertebral fracture and head contusion increasing with age, and rib fracture decreasing with age. Conclusion: In a large cohort of older adults with trauma (n= 38,000, we found, with advancing age, a decrease in trauma alert level, despite an increase in mortality and a decrease in demographic diversity. This descriptive study provides a framework for future research on the relationship between age and blunt traumatic injury in older adults.

Injury rates of the German Women’s American Football National Team from 2009 to 2011

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Marco Ezechieli

2012-09-01

Full Text Available American football is one of the leading causes of athletic-related injuries. Injury rates in female elite players are mostly unknown. We hypothesized that the injury rates of female was comparable to those in men’s football during practice, as well as games. From 2009 to 2011, injury data were collected from the German female national team during training camps, World Championship 2010 and International friendly matches. The injury was categorized by location on the body and recorded as fracture/dislocation, strain, concussion, contusion or other injury. Injury rates were determined based on the exposure of an athlete to a game or practice event. The injury rate was calculated as the ratio of injuries per 1000 athlete exposures (AE. The rate of injury was significantly higher during games (58.8/1000 AE than practices [16.3/1000 AE, (P<0.01]. Furthermore, the injury rate in the tryouts was significantly higher (24.05/1000 AE compared to other training sessions with the national team (11.24/1000 AE. Our findings show that the injury rates in female elite American football players can be compared to those described for male players. Higher injury rates during matches than in training should also be underlined.

Metabolic alterations in patients who develop traumatic brain injury (TBI)-induced hypopituitarism.

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Prodam, F; Gasco, V; Caputo, M; Zavattaro, M; Pagano, L; Marzullo, P; Belcastro, S; Busti, A; Perino, C; Grottoli, S; Ghigo, E; Aimaretti, G

2013-08-01

Hypopituitarism is associated with metabolic alterations but in TBI-induced hypopituitarism data are scanty. The aim of our study was to evaluate the prevalence of naïve hypertension, dyslipidemia, and altered glucose metabolism in TBI-induced hypopituitarism patients. Cross-sectional retrospective study in a tertiary care endocrinology center. 54 adult patients encountering a moderate or severe TBI were evaluated in the chronic phase (at least 12 months after injury) after-trauma. Presence of hypopituitarism, BMI, hypertension, fasting blood glucose and insulin levels, oral glucose tolerance test (if available) and a lipid profile were evaluated. The 27.8% of patients showed various degrees of hypopituitarism. In particular, 9.3% had total, 7.4% multiple and 11.1% isolated hypopituitarism. GHD was present in 22.2% of patients. BMI was similar between the two groups. Hypopituitaric patients presented a higher prevalence of dyslipidemia (phypopituitaric patients. In particular, triglycerides (phypopituitaric TBI patients. We showed that long-lasting TBI patients who develop hypopituitarism frequently present metabolic alterations, in particular altered glucose levels, insulin resistance and hypertriglyceridemia. In view of the risk of premature cardiovascular death in hypopituitaric patients, major attention has to been paid in those who encountered a TBI, because they suffer from the same comorbidities and may present other deterioration factors due to complex pharmacological treatments and restriction in participation in life activities and healthy lifestyle. Copyright © 2013 Elsevier Ltd. All rights reserved.

Axillary nerve injury associated with sports.

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Lee, Sangkook; Saetia, Kriangsak; Saha, Suparna; Kline, David G; Kim, Daniel H

2011-11-01

The aim of this retrospective study was to present and investigate axillary nerve injuries associated with sports. This study retrospectively reviewed 26 axillary nerve injuries associated with sports between the years 1985 and 2010. Preoperative status of the axillary nerve was evaluated by using the Louisiana State University Health Science Center (LSUHSC) grading system published by the senior authors. Intraoperative nerve action potential recordings were performed to check nerve conduction and assess the possibility of resection. Neurolysis, suture, and nerve grafts were used for the surgical repair of the injured nerves. In 9 patients with partial loss of function and 3 with complete loss, neurolysis based on nerve action potential recordings was the primary treatment. Two patients with complete loss of function were treated with resection and suturing and 12 with resection and nerve grafting. The minimum follow-up period was 16 months (mean 20 months). The injuries were associated with the following sports: skiing (12 cases), football (5), rugby (2), baseball (2), ice hockey (2), soccer (1), weightlifting (1), and wrestling (1). Functional recovery was excellent. Neurolysis was performed in 9 cases, resulting in an average functional recovery of LSUHSC Grade 4.2. Recovery with graft repairs averaged LSUHSC Grade 3 or better in 11 of 12 cases Surgical repair can restore useful deltoid function in patients with sports-associated axillary nerve injuries, even in cases of severe stretch-contusion injury.

A prospective study of downhill mountain biking injuries.

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Becker, Johannes; Runer, Armin; Neunhäuserer, Daniel; Frick, Nora; Resch, Herbert; Moroder, Philipp

2013-05-01

Downhill mountain biking (DMB) has become an increasingly popular extreme sport in the last few years with high velocities and bold manoeuvres. The goal of this study was to provide information on the pattern and causes of injuries in order to provide starting points for injury prevention measures. We performed a monthly e-mail-based prospective survey of 249 riders over one summer season ranging from April until September 2011. A total of 494 injuries occurred during the 29 401 h of downhill exposure recorded, of these 65% were mild, 22% moderate and 13% severe, of which 41% led to a total restriction greater than 28 days. The calculated overall injury rate was 16.8 injuries per 1000 h of exposure. For experts it was 17.9 injuries per 1000 h of exposure, which is significantly higher than the 13.4 for professional riders (OR 1.34; 95% CI, 1.02 to 1.75; p=0.03). A significantly higher rate of injury was reported during competition (20 per 1000 h) than during practice (13 per 1000 h) (OR 1.53; 95% CI, 1.16 to 2.01; p=0.0022). The most commonly injured body site was the lower leg (27%) followed by the forearm (25%). Most frequent injury types were abrasions (64%) and contusions (56%). Main causes of injury reported by the riders were riding errors (72%) and bad trail conditions (31%). According to our data DMB can be considered an extreme sport conveying a high risk of serious injury. Strategies of injury prevention should focus on improvements in riders' technique, checking of local trail conditions and protective equipment design.

Childhood motocross truncal injuries: high-velocity, focal force to the chest and abdomen

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Kennedy, Raelene D; Potter, D Dean; Osborn, John B; Zietlow, Scott; Zarroug, Abdalla E; Moir, Christopher R; Ishitani, Michael B; McIntosh, Amy

2012-01-01

Objectives To review the need for operative intervention and critical care services for motocross truncal injuries in children. Design cohort Retrospective review of patients identified via the hospital trauma registry. Setting Our Level 1 Pediatric Trauma Center serves five motocross tracks. These patients require frequent medical care for injuries. Participants All patients ≤17 years of age with truncal injuries sustained during motocross activities, between 2000 and 2011, were identified through the trauma registry. Primary and secondary outcome measures Operative intervention, intensive care unit (ICU) admission, length of stay, morbidity and demographics were reviewed. Results Motocross injured 162 children. Thirty (18.5%) were thoracic or abdominal injuries. Operative intervention was required in eight (27%) patients. Mean injury severity score (ISS) was 11.8. ICU admission was required in 50% and average hospital length of stay was 4.1 days. The most common injuries include pulmonary contusion, pneumothorax, spleen and liver lacerations. 13% of subjects suffered truncal injury from motocross on more than one occasion. Conclusions Paediatric motocross-related truncal injuries are significant. Surgical intervention is required in 27% of patients. The lower ISS incurred from motocross combined with high surgical and ICU admission rates suggests focal high-impact injuries to the chest and abdomen. Despite significant injury, 13% of motocross patients suffer recurrent injuries. Parents and children need injury prevention education. PMID:23166134

Camellia sinensis Prevents Perinatal Nicotine-Induced Neurobehavioral Alterations, Tissue Injury, and Oxidative Stress in Male and Female Mice Newborns

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Ajarem, Jamaan S.; Al-Basher, Gadh; Allam, Ahmed A.

2017-01-01

Nicotine exposure during pregnancy induces oxidative stress and leads to behavioral alterations in early childhood and young adulthood. The current study aimed to investigate the possible protective effects of green tea (Camellia sinensis) against perinatal nicotine-induced behavioral alterations and oxidative stress in mice newborns. Pregnant mice received 50 mg/kg C. sinensis on gestational day 1 (PD1) to postnatal day 15 (D15) and were subcutaneously injected with 0.25 mg/kg nicotine from PD12 to D15. Nicotine-exposed newborns showed significant delay in eye opening and hair appearance and declined body weight at birth and at D21. Nicotine induced neuromotor alterations in both male and female newborns evidenced by the suppressed righting, rotating, and cliff avoidance reflexes. Nicotine-exposed newborns exhibited declined memory, learning, and equilibrium capabilities, as well as marked anxiety behavior. C. sinensis significantly improved the physical development, neuromotor maturation, and behavioral performance in nicotine-exposed male and female newborns. In addition, C. sinensis prevented nicotine-induced tissue injury and lipid peroxidation and enhanced antioxidant defenses in the cerebellum and medulla oblongata of male and female newborns. In conclusion, this study shows that C. sinensis confers protective effects against perinatal nicotine-induced neurobehavioral alterations, tissue injury, and oxidative stress in mice newborns. PMID:28588748

Antioxidant vitamins C, E and coenzyme Q10 vs Dexamethasone: comparisons of their effects in pulmonary contusion model

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Gokce Mertol

2012-09-01

Full Text Available Abstract Background The goal of our study is to evaluate the effects of antioxidant vitamins (vitamin C and E, Coenzyme Q10 (CoQ10 and dexamethasone (Dxm in experimental rat models with pulmonary contusion (PC. Methods Rats were randomly divided into six groups. Except for the control, all subgroups had a moderate pulmonary contusion. Animals in the group I and group II received intraperitoneal saline, group III received 10mg.kg-1 CoQ10 group IV received 100mg.kg-1 vitamin C, group V received 150mg.kg-1 vitamin E, and group VI received 10mg.kg-1 Dxm. Blood gas analysis, serum nitric oxide (NO and malondialdehyde (MDA levels as well as superoxide dismutase (SOD activity assays, bronchoalveolar lavage (BAL fluid and histopathological examination were performed. Results Administration of CoQ10 resulted in a significant increase in PaO2 values compared with the group I (p = 0.004. Levels of plasma MDA in group II were significantly higher than those in the group I (p = 0.01. Early administration of vitamin C, CoQ10, and Dxm significantly decreased the levels of MDA (p = 0.01. Lung contusion due to blunt trauma significantly decreased SOD activities in rat lung tissue compared with group I (p = 0.01. SOD levels were significantly elevated in animals treated with CoQ10, Vitamin E, or Dxm compared with group II (p = 0.01. Conclusions In our study, CoQ10, vitamin C, vitamin E and Dxm had a protective effect on the biochemical and histopathological outcome of PC after experimental blunt thorax trauma.

Retrospective cohort analysis of chest injury characteristics and concurrent injuries in patients admitted to hospital in the Wenchuan and Lushan earthquakes in Sichuan, China.

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Zheng, Xi; Hu, Yang; Yuan, Yong; Zhao, Yong-Fan

2014-01-01

The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity. We compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients. The incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries. Previous studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake-related chest injuries.

Retrospective cohort analysis of chest injury characteristics and concurrent injuries in patients admitted to hospital in the Wenchuan and Lushan earthquakes in Sichuan, China.

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Xi Zheng

Full Text Available BACKGROUND: The aim of this study was to compare retrospectively the characteristics of chest injuries and frequencies of other, concurrent injuries in patients after earthquakes of different seismic intensity. METHODS: We compared the cause, type, and body location of chest injuries as well as the frequencies of other, concurrent injuries in patients admitted to our hospital after the Wenchuan and Lushan earthquakes in Sichuan, China. We explored possible relationships between seismic intensity and the causes and types of injuries, and we assessed the ability of the Injury Severity Score, New Injury Severity Score, and Chest Injury Index to predict respiratory failure in chest injury patients. RESULTS: The incidence of chest injuries was 9.9% in the stronger Wenchuan earthquake and 22.2% in the less intensive Lushan earthquake. The most frequent cause of chest injuries in both earthquakes was being accidentally struck. Injuries due to falls were less prevalent in the stronger Wenchuan earthquake, while injuries due to burial were more prevalent. The distribution of types of chest injury did not vary significantly between the two earthquakes, with rib fractures and pulmonary contusions the most frequent types. Spinal and head injuries concurrent with chest injuries were more prevalent in the less violent Lushan earthquake. All three trauma scoring systems showed poor ability to predict respiratory failure in patients with earthquake-related chest injuries. CONCLUSIONS: Previous studies may have underestimated the incidence of chest injury in violent earthquakes. The distributions of types of chest injury did not differ between these two earthquakes of different seismic intensity. Earthquake severity and interval between rescue and treatment may influence the prevalence and types of injuries that co-occur with the chest injury. Trauma evaluation scores on their own are inadequate predictors of respiratory failure in patients with earthquake

Injuries in karate: systematic review.

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Thomas, Roger E; Ornstein, Jodie

2018-05-22

to identify all studies of Karate injuries and assess injury rates, types, location, and causes. Six electronic and four grey literature databases were searched. Two reviewers independently assessed titles/abstracts, abstracted data and assessed risk-of-bias with the Newcastle-Ottawa scale. Average injury rates/1000AE (AE = athletic-encounter) and/1000minutesAE, injury location and type weighted by study size were calculated. In competitions rates of injury/1000AE and/1000 minutesAE were similar for males (111.4/1000AE, 75.4/1000 minAE) and females (105.8/1000AE, 72.8/1000 minAE). Location of injury rates/1000AE for males were 44.0 for head/neck, 11.9 lower extremities, 8.1 torso and 5.4 upper extremities and were similar for females: 41.2 head/neck, 12.4 lower extremities, 9.1 torso and 6.3 upper extremities. Injury rates varied widely by study. Rates/1000AE for type of injury were contusions/abrasions/lacerations/bruises/tooth avulsion for males (68.1) and females (30.4); hematomas/bleeding/epistaxis males (11.4) and females (12.1); strains/sprains males (3.5) and females (0.1); dislocations males (2.9) and females (0.9); concussions males (2.5) and females (3.9); and fractures males (2.9) and females (1.4). Punches were a more common mechanism of injury for males (59.8) than females (40.8) and kicks similar (males 19.7, females 21.7). Weighted averages were not calculated for weight class or belt colour because there were too few studies. Nineteen injury surveys reported annual injury rates from 30% to rates ten times higher but used different reporting methods. Studies provided no data to explain wide rate ranges. Studies need to adopt one injury definition, one data-collection form, and collect comprehensive data for each study for both training and competitions. More data are needed to measure the effect of weight, age and experience on injuries, rates and types of injury during training, and for competitors with high injury rates. RCTs are needed of

Injury Risk Factors in a Small-Scale Gold Mining Community in Ghana’s Upper East Region

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Long, Rachel N.; Sun, Kan; Neitzel, Richard L.

2015-01-01

Occupational injury is one of many health concerns related to small-scale gold mining (ASGM), but few data exist on the subject, especially in sub-Saharan Africa. In 2011 and 2013, we examined accidents, injuries, and potential risk factors in a Ghanaian ASGM community. In 2011, 173 participants were surveyed on occupational history and health, and 22 of these were surveyed again in 2013. Injury rates were estimated at 45.5 and 38.5 injuries per 100 person-years in 2011 and in 2013, respectively; these rates far surpass those of industrialized mines in the U.S. and South Africa. Demographic and job characteristics generally were not predictive of injury risk, though there was a significant positive association with injury risk for males and smokers. Legs and knees were the most common body parts injured, and falling was the most common cause of injury. The most common type of injuries were cuts or lacerations, burns and scalds, and contusions and abrasions. Only two miners had ever received any occupational safety training, and PPE use was low. Our results suggest that injuries should be a priority area for occupational health research in ASGM. PMID:26213958

Injury Risk Factors in a Small-Scale Gold Mining Community in Ghana’s Upper East Region

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Rachel N. Long

2015-07-01

Full Text Available Occupational injury is one of many health concerns related to small-scale gold mining (ASGM, but few data exist on the subject, especially in sub-Saharan Africa. In 2011 and 2013, we examined accidents, injuries, and potential risk factors in a Ghanaian ASGM community. In 2011, 173 participants were surveyed on occupational history and health, and 22 of these were surveyed again in 2013. Injury rates were estimated at 45.5 and 38.5 injuries per 100 person-years in 2011 and in 2013, respectively; these rates far surpass those of industrialized mines in the U.S. and South Africa. Demographic and job characteristics generally were not predictive of injury risk, though there was a significant positive association with injury risk for males and smokers. Legs and knees were the most common body parts injured, and falling was the most common cause of injury. The most common type of injuries were cuts or lacerations, burns and scalds, and contusions and abrasions. Only two miners had ever received any occupational safety training, and PPE use was low. Our results suggest that injuries should be a priority area for occupational health research in ASGM.

Sports injuries in school gaelic football: a study over one season.

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Watson, A W

1996-01-01

School football injuries were studied over the seven months of one season on 150 males aged 16.94 +/- 0.82 years. Training averaged 4.13 +/- 1.47 hours per week and matches 1.84 +/- 0.60 hours per week. Mean time injured was: 0.51 +/- 1.7 days in hospital, 34.27 +/- 37.08 days off sport and 13.98 +/- 5.22 days of restricted activity. There were 136 match and 63 training injuries giving 175.98 injuries per 10000 hours of matches and 31.06 injuries per 10000 hours of training. Injuries were treated as follows: hospital 83, general practitioners 51, physiotherapists 28, no treatment 38. The most common injuries were: ankle sprain (11.6% of the total), hamstring strain (6.5%), contusion (6.5%) back strain (6%) knee sprain (5.0%), finger sprain (5.0%), other muscle strains (5.0%), fracture of the wrist (5.0%), dislocation of the finger (4.5%), overuse injury of the back (4.0%), tenosynovitis (3.5%), fracture of the ankle (3.0%). Thirteen injuries were to goal-keepers, 85 to backs, 31 to mid-field players and 70 to forwards. In 34.83% of the injuries foul play was given as the major cause. This was followed by "Lack of fitness", "Poor kit or boots" and "Previous injury" (all 11.24%). The most common minor cause was "Poor state of the pitch" (17.42% of injuries).

Clinical utility of MR FLAIR imaging for head injuries

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Ashikaga, Ryuichiro [Kinki Univ., Osaka-Sayama, Osaka (Japan). School of Medicine

1996-12-01

To study the utility of fluid attenuated inversion recovery (FLAIR) MR images in the evaluation of traumatic head injury, 56 patients with traumatic head injuries were examined with long TR/TE spin-echo (SE) sequences and FLAIR sequences. In 40 of them, long TR/short TE images were added to those sequences. Careful readings of MR images were done by two well-trained neuroradiologists. The chi-square test was used for statistical evaluation of our results. The relative sensitivities of FLAIR images were significantly better than those of long TR/TE, long TR/short TE images for the detection of diffuse axonal injury (p<0.01), cortical contusion (p<0.01), and subdural hematoma (p<0.01 for long TR/TE, p<0.05 for long TR/short TE). The number of cases of epidural hematoma and brainstem injury was too small for statistical significance to be determined. In 9 patients with corpus callosum injuries. FLAIR images demonstrated the lesions as abnormally high signal intensity in the septum pellucidum and fornix. Only sagittal FLAIR images could definitely discriminate the traumatic lesions of the fornix from the surrounding CSF. In addition, FLAIR images could easily discriminate DAI of the corpus callosum from CSF of the cavum velli interpositi. MR FLAIR images were found to be useful for detecting traumatic head injuries. (author)

Altered metabolites of the rat hippocampus after mild and moderate traumatic brain injury - a combined in vivo and in vitro 1 H-MRS study.

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Singh, Kavita; Trivedi, Richa; Verma, Ajay; D'souza, Maria M; Koundal, Sunil; Rana, Poonam; Baishya, Bikash; Khushu, Subash

2017-10-01

Traumatic brain injury (TBI) has been shown to affect hippocampus-associated learning, memory and higher cognitive functions, which may be a consequence of metabolic alterations. Hippocampus-associated disorders may vary depending on the severity of injury [mild TBI (miTBI) and moderate TBI (moTBI)] and time since injury. The underlying hippocampal metabolic irregularities may provide an insight into the pathological process following TBI. In this study, in vivo and in vitro proton magnetic resonance spectroscopy ( 1 H-MRS) data were acquired from the hippocampus region of controls and TBI groups (miTBI and moTBI) at D0 (pre-injury), 4 h, Day 1 and Day 5 post-injury (PI). In vitro MRS results indicated trauma-induced changes in both miTBI and moTBI; however, in vivo MRS showed metabolic alterations in moTBI only. miTBI and moTBI showed elevated levels of osmolytes indicating injury-induced edema. Altered levels of citric acid cycle intermediates, glutamine/glutamate and amino acid metabolism indicated injury-induced aberrant bioenergetics, excitotoxicity and oxidative stress. An overall similar pattern of pathological process was observed in both miTBI and moTBI, with the distinction of depleted N-acetylaspartate levels (indicating neuronal loss) at 4 h and Day 1 and enhanced lactate production (indicating heightened energy depletion leading to the commencement of the anaerobic pathway) at Day 5 in moTBI. To the best of our knowledge, this is the first study to investigate the hippocampus metabolic profile in miTBI and moTBI simultaneously using in vivo and in vitro MRS. Copyright © 2017 John Wiley & Sons, Ltd.

Strengthening Injury Surveillance System in Iran

Institute of Scientific and Technical Information of China (English)

Seyed Abbas Motevalian; Mashyaneh Haddadi; Hesam Akbari; Reza Khorramirouz; Soheil Saadat; Arash Tehrani; Vafa Rahimi-Movaghar

2011-01-01

Objective:To strengthen the current Injury Surveillance System (IS System) in order to better monitor injury conditions,improve protection ways and promote safety.Methods:At first we carried out a study to evaluate the frameworks of IS System in the developed countries.Then all the available documents from World Health OrganizationEastern Mediterranean Regional Organization,as well as Minister of Health and Medical Education concerning Iran were reviewed.Later a national stakeholder's consultation was held to collect opinions and views.A national workshop was also intended for provincial representatives from 41 universities to identify the barriers and limitations of the existing program and further to strengthen injury surveillance.Results:The evaluation of the current IS System revealed many problems,mainly presented as lack of accurate pre- and post-hospital death registry,need of precise injury data registry in outpatient medical centers,incomplete injury data registry in hospitals and lack of accuracy in definition of variables in injury registry.The five main characteristics of current IS System including flexibility,acceptability,simplicity,usefulness and timeliness were evaluated as moderate by experts.Contusions:Major revisions must be considered in the current IS System in Iran.The following elements should be added to the questionnaire:identifier,manner of arrival to the hospital,situation of the injured patient,consumption of alcohol and opioids,other involved participants in the accident,intention,severity and site of injury,side effects of surgery and medication,as well as one month follow-up results.Data should be collected from 10％ of all hospitals in Iran and analyzed every 3 months.Simultaneously data should be online to be retrieved by researches.

Autophagy Limits Endotoxemic Acute Kidney Injury and Alters Renal Tubular Epithelial Cell Cytokine Expression.

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Jeremy S Leventhal

Full Text Available Sepsis related acute kidney injury (AKI is a common in-hospital complication with a dismal prognosis. Our incomplete understanding of disease pathogenesis has prevented the identification of hypothesis-driven preventive or therapeutic interventions. Increasing evidence in ischemia-reperfusion and nephrotoxic mouse models of AKI support the theory that autophagy protects renal tubular epithelial cells (RTEC from injury. However, the role of RTEC autophagy in septic AKI remains unclear. We observed that lipopolysaccharide (LPS, a mediator of gram-negative bacterial sepsis, induces RTEC autophagy in vivo and in vitro through TLR4-initiated signaling. We modeled septic AKI through intraperitoneal LPS injection in mice in which autophagy-related protein 7 was specifically knocked out in the renal proximal tubules (ATG7KO. Compared to control littermates, ATG7KO mice developed more severe renal dysfunction (24hr BUN 100.1mg/dl +/- 14.8 vs 54.6mg/dl +/- 11.3 and parenchymal injury. After injection with LPS, analysis of kidney lysates identified higher IL-6 expression and increased STAT3 activation in kidney lysates from ATG7KO mice compared to controls. In vitro experiments confirmed an altered response to LPS in RTEC with genetic or pharmacological impairment of autophagy. In conclusion, RTEC autophagy protects against endotoxin induced injury and regulates downstream effects of RTEC TLR4 signaling.

Prognosis of head injury. In relation to age, CT findings and the GCS on admission

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Tanaka, Satoshi; Kamei, Ichiro; Ooiwa, Yoshitsugu; Hyotani, Genhachi; Yabumoto, Michio; Kuriyama, Tsuyoshi [Japanese Red Cross Society, Wakayama (Japan). Wakayama Medical Center; Kakishita, Koji; Inui, Yoshiro

1996-02-01

We have carried out a retrospective study of head injury patients to determine the factors that predict their outcomes. The subjects consisted of 74 head injury patients (Glasgow Coma Scale: 3-12) treated at our hospital from January, 1989 to March, 1994. Age, CT findings and the GCS on admission were investigated as outcome-predicting factors. CT findings were classified according to the TCDB (Traumatic Coma Data Bank) and the outcomes were evaluated using the Glasgow Outcome Scale 3 months after the head injury. In our study, the factors indicated favorable outcomes were as follows; age younger than 50 years old, GCS higher than 6, appearance of the basal cisterns on CT scan, existence of removable acute epidural hematoma. In contrast, the factors that indicated unfavorable outcomes were as follows; disappearance of the basal cisterns on CT scan, existence of apparent acute subdural hematoma and/or intracranial hematoma associated with cerebral contusion. Based on these findings, we can more accurately estimate the prognosis of head injury. (author)

Traumatic Rib Injury: Patterns, Imaging Pitfalls, Complications, and Treatment.

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Talbot, Brett S; Gange, Christopher P; Chaturvedi, Apeksha; Klionsky, Nina; Hobbs, Susan K; Chaturvedi, Abhishek

2017-01-01

The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures. Specific attention is also required for flail chest and for fractures due to pediatric nonaccidental trauma. Rib fractures are associated with significant morbidity and mortality, both of which increase as the number of fractured ribs increases. Key complications associated with rib fracture include pain, hemothorax, pneumothorax, extrapleural hematoma, pulmonary contusion, pulmonary laceration, acute vascular injury, and abdominal solid-organ injury. Congenital anomalies, including supernumerary or accessory ribs, vestigial anterior ribs, bifid ribs, and synostoses, are common and should not be confused with traumatic pathologic conditions. Nontraumatic mimics of traumatic rib injury, with or without fracture, include metastatic disease, primary osseous neoplasms (osteosarcoma, chondrosarcoma, Ewing sarcoma, Langerhans cell histiocytosis, and osteochondroma), fibrous dysplasia, and Paget disease. Principles of management include supportive and procedural methods of alleviating pain, treating complications, and stabilizing posttraumatic deformity. By recognizing and accurately reporting the imaging findings, the radiologist will add value to the care of patients with thoracic trauma. Online supplemental material is available for this article. © RSNA, 2017.

Sport Injuries of Karate During Training: An Epidemiologic Study in Iran.

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Ziaee, Vahid; Shobbar, Montazer; Lotfian, Sara; Ahmadinejad, Mahdi

2015-06-01

Karate is a public sport that has athletes in various age ranges and abundant active sport clubs in Iran. The pattern of injury in this sport in Iranian athletes seems different from other countries. This study was performed with the purpose of considering the incidence and type of injury of karate athletes aged below 30 years from Tehran, Iran clubs. In a cross-sectional study, 10 karate clubs were selected in Tehran. Clubs were selected based on a cluster method from 5 different geographical regions of Tehran. All injuries were collected based on athletes' or clubs' weekly report with a designed questionnaire. The injuries were classified according to: low, medium and severe injury. Collected data was analyzed with SPSS software version 17. 620 athletes were studied totally and incidence rate of injury per athletes was 16.1% and 20.2 per 100 athletes. Ninety percent of injuries were during bout practice, 6% during fitness and 4% during kata. The rate of injury was more common in athletes with weight less than 70 kg and lower sport experience (P ≤ 0.05). The commonest locations for injury were head and neck followed by trunk, lower and upper limb, respectively. Just 2 cases needed surgical intervention and no one led to decreased level of consciousness. The most common type of injury was contusion, bruise and superficial scratch (64%). Severe injury was uncommon in this study and similar to other Iranian studies head and neck had the most injuries. Athletes with lower experience and lower weight were associated with higher injuries.

Topical nonsteroidal anti-inflammatory drugs for the treatment of pain due to soft tissue injury: diclofenac epolamine topical patch

OpenAIRE

Lionberger, David

2010-01-01

David R Lionberger1, Michael J Brennan21Southwest Orthopedic Group, Houston, TX, USA; 2Department of Medicine, Bridgeport Hospital, Bridgeport, CT, USAAbstract: The objective of this article is to review published clinical data on diclofenac epolamine topical patch 1.3% (DETP) in the treatment of acute soft tissue injuries, such as strains, sprains, and contusions. Review of published literature on topical nonsteroidal anti-inflammatory drugs (NSAIDs), diclofenac, and DETP in patients with ac...

Apolipoprotein E as a novel therapeutic neuroprotection target after traumatic spinal cord injury.

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Cheng, Xiaoxin; Zheng, Yiyan; Bu, Ping; Qi, Xiangbei; Fan, Chunling; Li, Fengqiao; Kim, Dong H; Cao, Qilin

2018-01-01

Apolipoprotein E (apoE), a plasma lipoprotein well known for its important role in lipid and cholesterol metabolism, has also been implicated in many neurological diseases. In this study, we examined the effect of apoE on the pathophysiology of traumatic spinal cord injury (SCI). ApoE-deficient mutant (apoE -/- ) and wild-type mice received a T9 moderate contusion SCI and were evaluated using histological and behavioral analyses after injury. At 3days after injury, the permeability of spinal cord-blood-barrier, measured by extravasation of Evans blue dye, was significantly increased in apoE -/- mice compared to wild type. The inflammation and spared white matter was also significantly increased and decreased, respectively, in apoE -/- mice compared to the wild type ones. The apoptosis of both neurons and oligodendrocytes was also significantly increased in apoE -/- mice. At 42days after injury, the inflammation was still robust in the injured spinal cord in apoE -/- but not wild type mice. CD45+ leukocytes from peripheral blood persisted in the injured spinal cord of apoE -/- mice. The spared white matter was significantly decreased in apoE -/- mice compared to wild type ones. Locomotor function was significantly decreased in apoE -/- mice compared to wild type ones from week 1 to week 8 after contusion. Treatment of exogenous apoE mimetic peptides partially restored the permeability of spinal cord-blood-barrier in apoE -/- mice after SCI. Importantly, the exogenous apoE peptides decreased inflammation, increased spared white matter and promoted locomotor recovery in apoE -/- mice after SCI. Our results indicate that endogenous apoE plays important roles in maintaining the spinal cord-blood-barrier and decreasing inflammation and spinal cord tissue loss after SCI, suggesting its important neuroprotective function after SCI. Our results further suggest that exogenous apoE mimetic peptides could be a novel and promising neuroprotective reagent for SCI. Copyright �

[Injuries sustained by bus passengers in the municipality of Odense 1996-1999].

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Barsi, T; Faergemann, C; Larsen, L B

2001-10-22

Owing to several recent bus-related accidents in Denmark, we wished to investigate injuries sustained by passengers. From our ongoing registration of patients treated in the casualty department at Odense University Hospital, we identified all residents of Odense Municipality who had sustained injuries as bus passengers from 1996 to 1999. Market analysis and demographic information were used to calculate the incidence and risk. Over this four-year period, 327 consecutive injuries had been sustained by 246 bus passengers, 72 men and 174 women, mean ages 44 and 53 years. The incidence rate was 3.3 injured per 10,000 inhabitants per year, with no increasing tendency during the study period. The risk was 2.2 injured per 1,000,000 bus passengers per year, highest in women and increasing with age. Injuries most frequently occurred when the bus stopped (31%), as passengers were boarding or alighting (23%), or during collision with another vehicle (20%). Most commonly injured areas were the lower (30%) and upper (28%) extremities and the head or neck (27%). Contusions and sprains were the most common injuries (59%). The most common fractures were those of the humerus and hip region. Bus passenger injuries are not a growing problem. The incidence increases with age.

Cerebral oxygenation in contusioned vs. nonlesioned brain tissue: monitoring of PtiO2 with Licox and Paratrend.

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Sarrafzadeh, A S; Kiening, K L; Bardt, T F; Schneider, G H; Unterberg, A W; Lanksch, W R

1998-01-01

Brain tissue PO2 in severely head injured patients was monitored in parallel with two different PO2-microsensors (Licox and Paratrend). Three different locations of sensor placement were chosen: (1) both catheters into non lesioned tissue (n = 3), (2) both catheters into contusioned tissue (n = 2), and (3) one catheter (Licox) into pericontusional versus one catheter (Paratrend) into non lesioned brain tissue (n = 2). Mean duration of PtiO2-monitoring with both microsensors in parallel was 68.1 hours. Brain tissue PO2 varied when measured in lesioned and nonlesioned tissue. In non lesioned tissue both catheters closely correlated (delta Licox/Paratrend: mean PtiO2 delta lesioned/non lesioned: mean PtiO2: 10.3 mm Hg). In contusioned brain tissue PtiO2 was always below the "hypoxic threshold" of 10 mm Hg, independent of the type of microsensor used. During a critical reduction in cerebral perfusion pressure (PO2, only increased PtiO2 when measured in pericontusional and nonlesioned brain. To recognize critical episodes of hypoxia or ischemia, PtiO2-monitoring of cerebral oxygenation is recommended in nonlesioned brain tissue.

Ball-Contact Injuries in 11 National Collegiate Athletic Association Sports: The Injury Surveillance Program, 2009-2010 Through 2014-2015.

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Fraser, Melissa A; Grooms, Dustin R; Guskiewicz, Kevin M; Kerr, Zachary Y

2017-07-01

  Surveillance data regarding injuries caused by ball contact in collegiate athletes have not been well examined and are mostly limited to discussions of concussions and catastrophic injuries.   To describe the epidemiology of ball-contact injuries in 11 National Collegiate Athletic Association (NCAA) sports during the 2009-2010 through 2014-2015 academic years.   Descriptive epidemiology study.   Convenience sample of NCAA programs in 11 sports (men's football, women's field hockey, women's volleyball, men's baseball, women's softball, men's and women's basketball, men's and women's lacrosse, and men's and women's soccer) during the 2009-2010 through 2014-2015 academic years.   Collegiate student-athletes participating in 11 sports.   Ball-contact-injury rates, proportions, rate ratios, and proportion ratios with 95% confidence intervals were based on data from the NCAA Injury Surveillance Program during the 2009-2010 through 2014-2015 academic years.   During the 2009-2010 through 2014-2015 academic years, 1123 ball-contact injuries were reported, for an overall rate of 3.54/10 000 AEs. The sports with the highest rates were women's softball (8.82/10 000 AEs), women's field hockey (7.71/10 000 AEs), and men's baseball (7.20/10 000 AEs). Most ball-contact injuries were to the hand/wrist (32.7%) and head/face (27.0%) and were diagnosed as contusions (30.5%), sprains (23.1%), and concussions (16.1%). Among sex-comparable sports (ie, baseball/softball, basketball, and soccer), women had a larger proportion of ball-contact injuries diagnosed as concussions than men (injury proportion ratio = 2.33; 95% confidence interval = 1.63, 3.33). More than half (51.0%) of ball-contact injuries were non-time loss (ie, participation-restriction time common severe ball-contact injuries were concussions (n = 18) and finger fractures (n = 10).   Ball-contact-injury rates were the highest in women's softball, women's field hockey, and men's baseball. Although

Injuries in team sport tournaments during the 2004 Olympic Games.

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Junge, Astrid; Langevoort, Gijs; Pipe, Andrew; Peytavin, Annie; Wong, Fook; Mountjoy, Margo; Beltrami, Gianfranco; Terrell, Robert; Holzgraefe, Manfred; Charles, Richard; Dvorak, Jiri

2006-04-01

Several authors have analyzed the incidence of injuries in a given sport, but only a few have examined the exposure-related incidence of injuries in different types of sports using the same methodology. Analysis of the incidence, circumstances, and characteristics of injuries in different team sports during the 2004 Olympic Games. Cohort study; Level of evidence, 2. During the 2004 Olympic Games, injuries in 14 team sport tournaments (men's and women's soccer, men's and women's handball, men's and women's basketball, men's and women's field hockey, baseball, softball, men's and women's water polo, and men's and women's volleyball) were analyzed. After each match, the physician of the participating teams or the official medical representative of the sport completed a standardized injury report form. The mean response rate was 93%. A total of 377 injuries were reported from 456 matches, an incidence of 0.8 injuries per match (95% confidence interval, 0.75-0.91) or 54 injuries per 1000 player matches (95% confidence interval, 49-60). Half of all injuries affected the lower extremity; 24% involved the head or neck. The most prevalent diagnoses were head contusion and ankle sprain. On average, 78% of injuries were caused by contact with another player. However, a significantly higher percentage of noncontact (57%) versus contact injuries (37%) was expected to prevent the player from participating in his or her sport. Significantly more injuries in male players (46%) versus female players (35%) were expected to result in absence from match or training. The incidence, diagnosis, and causes of injuries differed substantially between the team sports. The risk of injury in different team sports can be compared using standardized methodology. Even if the incidence and characteristics of injuries are not identical in all sports, prevention of injury and promotion of fair play are relevant topics for almost all team sports.

Mesenchymal Stem Cells for the Prevention of Acute Respiratory Distress Syndrome after Pulmonary Contusion and Hemorrhagic Shock

Science.gov (United States)

2017-10-01

Contusion and Hemorrhagic Shock PRINCIPAL INVESTIGATOR: Martin Schreiber, MD CONTRACTING ORGANIZATION: Oregon Health & Science University Portland, OR...PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Oregon Health & Science University 3181 SW Sam Jackson Park Road, Portland, OR 97239 Blood Systems...extubated the animals was not logistically or physically feasible. To improve the welfare of the animal and consistency in the model, we revised our model

Surveyed opinion of American trauma surgeons in management of colon injuries.

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Eshraghi, N; Mullins, R J; Mayberry, J C; Brand, D M; Crass, R A; Trunkey, D D

1998-01-01

Primary repair or resection and anastomosis of colon wounds have been advocated in many recent studies, but the proportion of trauma surgeons accepting these recommendations is unknown. To determine the current preferences of American trauma surgeons for colon injury management. Four hundred forty-nine members of the American Association for the Surgery of Trauma were surveyed regarding their preferred management of eight types of colon wounds among three options: diverting colostomy (DC), primary repair (PR), or resection and anastomosis (RA). The influence of selected patient factors and surgeons' characteristics on the choice of management was also surveyed. Seventy-three percent of surgeons completed the survey. Ninety-eight percent chose PR for at least one type of injury. Thirty percent never selected DC. High-velocity gunshot wound was the only injury for which the majority (54%) would perform DC. More than 55% of the surgeons favored RA when the isolated colon injury was a contusion with possible devascularization, laceration greater than 50% of the diameter, or transection. Surgeons who managed five or fewer colon wounds per year chose DC more frequently (p colon wounds per year. The prevailing opinion of trauma surgeons favors primary repair or resection of colon injuries, including anastomosis of unprepared bowel. Surgeons who manage fewer colon wounds prefer colostomy more frequently.

Pediatric martial arts injuries presenting to Emergency Departments, United States 1990-2003.

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Yard, Ellen E; Knox, Christy L; Smith, Gary A; Comstock, R Dawn

2007-08-01

Although an estimated 6.5 million United States (US) children aged 6-17 practiced a martial art in 2004, there have been no nationally representative studies comparing pediatric injuries among the three most popular disciplines, karate, taekwondo, and judo. Describe pediatric martial arts injuries presenting to a representative sample of US Emergency Departments (EDs) from 1990 to 2003. We reviewed all martial arts injuries captured by the US Consumer Product Safety Commission's (CPSC), National Electronic Injury Surveillance System (NEISS). An estimated 128,400 children injuries from 1990 to 2003. Injured tended to be male (73.0%) and had a mean age of 12.1 years. Most injuries were attributed to karate (79.5%). The most common mechanism of injury was being kicked (25.6%), followed by falling (20.6%) and kicking (18.0%). The majority of injuries occurred to the lower leg/foot/ankle (30.1%) and hand/wrist (24.5%). The most common injury diagnoses were sprains/strains (29.3%), contusions/abrasions (27.8%), and fractures (24.6%). Participants in judo sustained significantly higher proportions of shoulder/upper arm injuries than karate (IPR=4.31, 95% CI: 2.84-6.55) or taekwondo (IPR=9.75, 95% CI: 3.53-26.91) participants. There were also higher proportions of neck injuries sustained by judo participants compared to karate (IPR=4.73, 95% CI: 1.91-11.70) or taekwondo (IPR=4.17, 95% CI: 1.02-17.06) participants. Pediatric martial arts injuries differ by discipline. Understanding these injury patterns can assist with the development of discipline-specific preventive interventions.

Terror explosive injuries: a comparison of children, adolescents, and adults.

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Jaffe, Dena H; Peleg, Kobi

2010-01-01

We sought to characterize injuries and outcomes from terror explosions with specific attention to children (0-10 years) and adolescents (11-15 years) compared to adults (16-45 years). Terror explosions target vulnerable populations and result in multidimensional injuries that may vary according to age group. The relative dearth of information regarding terror-related injuries among children inhibits proper preparedness and optimum management during such an event. A retrospective study was performed using data from the national Israel Trauma Registry (October 2000 to December 2005). Included were civilians and nonactive military personnel hospitalized as a result of a terror explosion. During the 5.3-year study period, 49 children (0-10 years), 65 adolescents (11-15 years), and 723 adults (16-45 years) were hospitalized from terror explosions. Children were more likely than adults to sustain severe injuries (27% vs. 12%) and traumatic brain injury (35% vs. 20%) and less likely to sustain injuries to their extremities (35% vs. 57%) or open wounds (39% vs. 59%) (P profile was similar to that of adults, however, adolescents presented with less internal injuries, more contusions, and superficial wounds to extremities and were more likely to require surgery for mild to moderate wounds. Differences in hospital utilization and outcomes by age groups were observed when data were stratified by injury severity. Compared to adults, children, and adolescents exposed to terror explosions present with different injuries and hospital utilization and outcomes. These results further confirm that preparedness of a pediatric healthcare system is essential for effective management in the event of a future mass casualty incident.

Paediatric head injuries in the Kwazulu-Natal Province of South Africa: a developing country perspective.

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Okyere-Dede, Ebenezer K; Nkalakata, Munyaradzi C; Nkomo, Tshepo; Hadley, G P; Madiba, Thandinkosi E

2013-01-01

We investigated the causes, management and outcome of head injuries in paediatric patients admitted to the paediatric surgery unit at King Edward VIII Hospital over a 3-year period, from 1999 to 2001. There were 506 patients (331 male; M:F ratio 2:1) and the mean age was 71.99 +36.8 months (2 weeks to 180 months). The injuries were due to: motor vehicle crashes (324); falls (121); assault (30); inadvertent injury (23); and unknown (11). Forty-nine patients (9%) were admitted with a Glasgow Coma Scale ≤8. The most common intracranial pathology on computed tomography was: intracranial haematoma/haemorrhage (44); contusion (16); and brain oedema (10). Nineteen patients (3.4%) underwent neurosurgical intervention and the rest were managed conservatively. Eighteen died in hospital (3.6%). The mean hospital stay was 5 ± 12 days. Twenty-three patients (4.5%) were discharged with neurological sequelae. Few paediatric patients are admitted with severe head injury: the majority from blunt injury caused by motor vehicle crashes. Management mainly requires simple neurological observation in a general ward with a surprisingly good prognosis. Specific protocols for paediatric head injuries have been proposed based on these findings.

Stiletto stabbing: penetrating injury to the hypothalamus with hyperacute diabetes insipidus.

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Itshayek, Eyal; Gomori, John Moshe; Spektor, Sergey; Cohen, José E

2010-12-01

Diabetes insipidus (DI) is a well documented complication observed after traumatic head injuries. We report a case of hyperacute onset DI in a 19-year-old male who sustained a hypothalamic-pituitary injury when he was stabbed in the head with a 30-cm long thin-bladed knife. At CT, our patient showed significant hemorrhagic contusions of the lower hypothalamus. He developed polydipsia, polyuria, and mild hypernatremia in the Emergency Department. Diagnostic digital subtraction angiography showed a hypervascular congestive pituitary gland with prominent draining veins. On the third day his hypernatremia became severe (183mEq/L). He was managed with parenteral fluids and a regimen of intranasal DDAVP (1-desamino 8-d-arginine vasopressin), leading to improved plasmatic sodium levels, urine output, and urinary specific gravity. In patients presenting with hyperacute posttraumatic DI, emergency room physicians and neurosurgeons should rule out direct injury to the hypothalamus and/or the posterior lobe of the pituitary, and initiate early pharmacological treatment. Copyright © 2010 Elsevier B.V. All rights reserved.

Dynamic alteration of the colonic microbiota in intestinal ischemia-reperfusion injury.

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Fan Wang

Full Text Available Intestinal ischemia-reperfusion (I/R plays an important role in critical illnesses. Gut flora participate in the pathogenesis of the injury. This study is aimed at unraveling colonic microbiota alteration pattern and identifying specific bacterial species that differ significantly as well as observing colonic epithelium change in the same injury model during the reperfusion time course.Denaturing gradient gel electrophoresis (DGGE was used to monitor the colonic microbiota of control rats and experimental rats that underwent 0.5 hour ischemia and 1, 3, 6, 12, 24, and 72 hours following reperfusion respectively. The microbiota similarity, bacterial diversity and species that characterized the dysbiosis were estimated based on the DGGE profiles using a combination of statistical approaches. The interested bacterial species in the gel were cut and sequenced and were subsequently quantified and confirmed with real-time PCR. Meanwhile, the epithelial barrier was checked by microscopy and D-lactate analysis. Colonic flora changed early and differed significantly at 6 hours after reperfusion and then started to recover. The shifts were characterized by the increase of Escherichia coli and Prevotella oralis, and Lactobacilli proliferation together with epithelia healing.This study shows for the first time that intestinal ischemia-reperfusion results in colonic flora dysbiosis that follows epithelia damage, and identifies the bacterial species that contribute most.

Serial Diffusion Tensor Imaging In Vivo Predicts Long-Term Functional Recovery and Histopathology in Rats following Different Severities of Spinal Cord Injury

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Patel, Samir P.; Smith, Taylor D.; VanRooyen, Jenna L.; Powell, David; Cox, David H.; Sullivan, Patrick G.

2016-01-01

Abstract The current study demonstrates the feasibility of using serial magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) in vivo to quantify temporally spinal cord injury (SCI) pathology in adult female Sprague-Dawley rats that were scanned prior to a moderate or severe upper lumbar contusion SCI. Injured rats were behaviorally tested for hind limb locomotion (Basso, Beattie, Bresnahan [BBB] scores) weekly for 4 weeks and scanned immediately after each session, ending with terminal gait analyses prior to euthanasia. As a measure of tissue integrity, fractional anisotropy (FA) values were significantly lower throughout the spinal cord in both injury cohorts at all time-points examined versus pre-injury. Moreover, FA values were significantly lower following severe versus moderate SCI at all time-points, and FA values at the injury epicenters at all time-points were significantly correlated with both spared white and gray matter volumes, as well as lesion volumes. Critically, quantified FA values at subacute (24 h) and all subsequent time-points were highly predictive of terminal behavior, reflected in significant correlations with both weekly BBB scores and terminal gait parameters. Critically, the finding that clinically relevant subacute (24 h) FA values accurately predict long-term functional recovery may obviate long-term studies to assess the efficacy of therapeutics tested experimentally or clinically. In summary, this study demonstrates a reproducible serial MRI procedure to predict the long-term impact of contusion SCI on both behavior and histopathology using subacute DTI metrics obtained in vivo to accurately predict multiple terminal outcome measures, which can be particularly valuable when comparing experimental interventions. PMID:26650623

INJURY PROFILE IN WOMEN SHOTOKAN KARATE CHAMPIONSHIPS IN IRAN(2004-2005

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Farzin Halabchi

2007-10-01

Full Text Available The aims of this paper were to record injury rates among Iranian women competitive Shotokan karate athletes and propose possible predisposing factors. A prospective recording of the injuries resulting from all matches in 6 consecutive women national Shotokan Karate Championships in all age groups in Iran (season 2004-2005 was performed. Data recorded included demographic characteristics (Age and Weight, athletic background (rank, years of experience, time spent training and previous injuries, type, location and reason for the injury, and the result of the match. Results indicate 186 recorded injuries from a total of 1139 bouts involving 1019 athletes, therefore there were 0.163 injury per bout [C.I. 95%: 0.142-0.184] and 183 injuries per 1000 athletes [C.I. 95%: 159-205]. Injuries were most commonly located in the head and neck (55.4% followed by the lower limb (21%, upper limb (12.9% and trunk (10.8%. Punches (48. 4% were associated with more injuries than kicks (33.3%. The injuries consisted of muscle strain and contusion (81, 43.6%, hematoma and epistaxis (49, 26.3%, lacerations and abrasions (28, 15. 1%, concussion (13, 7%, tooth avulsion or subluxation (3, 1.6%, joint dislocation (3, 1.6% and fractures (3, 1.6%. In conclusion, as the majority of injuries are minor, and severe or longstanding injuries are uncommon, it can be argued that shotokan karate is a relatively safe for females, despite its image as a combat sport, where ostensibly the aim appears to injure your opponent. Further research is needed to evaluate the effective strategies to minimize the risk of injuries

Aquaporins in Spinal Cord Injury: The Janus Face of AQP4

Science.gov (United States)

Nesic, Olivera; Guest, James D.; Zivadinovic, Dragoslava; Narayana, Ponnada A.; Herrera, Juan J.; Grill, Raymond J.; Mokkapati, Venkata U.L.; Gelman, Benjamin B.; Lee, Julieann

2010-01-01

Although malfunction of spinal cord water channels (aquaporins, AQP) likely contributes to severe disturbances in ion/water homeostasis after spinal cord injury (SCI), their roles are still poorly understood. Here we report and discuss the potential significance of changes in the AQP4 expression in human SCI that generates GFAP-labeled astrocytes devoid of AQP4, and GFAP-labeled astroglia that overexpress AQP4. We used a rat model of contusion SCI to study observed changes in human SCI. AQP4-negative astrocytes are likely generated during the process of SCI-induced replacement of lost astrocytes, but their origin and role in SCI remains to be investigated. We found that AQP4-overexpression is likely triggered by hypoxia. Our transcriptional profiling of injured rat cords suggests that elevated AQP4-mediated water influx accompanies increased uptake of chloride and potassium ions which represents a protective astrocytic reaction to hypoxia. However, unbalanced water intake also results in astrocytic swelling that can contribute to motor impairment, but likely only in milder injuries. In severe rat SCI, a low abundance of AQP4-overexpressing astrocytes was found during the motor recovery phase. Our results suggest that severe rat contusion SCI is a better model to analyze AQP4 functions after SCI. We found that AQP4 increases in the chronic post-injury phase are associated with the development of pain-like behavior in SCI rats, while possible mechanisms underlying pain development may involve astrocytic swelling-induced glutamate release. In contrast, the formation and size of fluid-filled cavities occurring later after SCI does not appear to be affected by the extent of increased AQP4 levels. Therefore, the effect of therapeutic interventions targeting AQP4 will depend not only on the time interval after SCI or animal models, but also on the balance between protective role of increased AQP4 in hypoxia and deleterious effects of ongoing astrocytic swelling. PMID

Trauma Reports. Volume 12, Number 6, November/December 2011

Science.gov (United States)

2011-12-01

lung injuries such as pneumothorax , Figure 3. Chest Radiograph of Intubated Trauma Patient with a Significant Pulmonary Contusion 6  Trauma ...Pulmonary Contusions Pulmonary contusions are a frequent complication of chest trauma and may have serious morbidity and mortality associated with...described in the medical literature by Morgani in 1761, when he noted extensive underlying parenchymal lung damage without evidence of chest wall trauma

Treatment with analgesics after mouse sciatic nerve injury does not alter expression of wound healing-associated genes

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Matt C Danzi

2016-01-01

Full Text Available Animal models of sciatic nerve injury are commonly used to study neuropathic pain as well as axon regeneration. Administration of post-surgical analgesics is an important consideration for animal welfare, but the actions of the analgesic must not interfere with the scientific goals of the experiment. In this study, we show that treatment with either buprenorphine or acetaminophen following a bilateral sciatic nerve crush surgery does not alter the expression in dorsal root ganglion (DRG sensory neurons of a panel of genes associated with wound healing. These findings indicate that the post-operative use of buprenorphine or acetaminophen at doses commonly suggested by Institutional Animal Care and Use Committees does not change the intrinsic gene expression response of DRG neurons to a sciatic nerve crush injury, for many wound healing-associated genes. Therefore, administration of post-operative analgesics may not confound the results of transcriptomic studies employing this injury model.

[Sport injuries in full contact and semi-contact karate].

Science.gov (United States)

Greier, K; Riechelmann, H; Ziemska, J

2014-03-01

Karate enjoys great popularity both in professional and recreational sports and can be classified into full, half and low contact styles. The aim of this study was the analysis of sports injuries in Kyokushinkai (full contact) and traditional Karate (semi-contact). In a retrospective study design, 215 active amateur karateka (114 full contact, 101 semi-contact) were interviewed by means of a standardised questionnaire regarding typical sport injuries during the last 36 months. Injuries were categorised into severity grade I (not requiring medical treatment), grade II (single medical treatment), grade III (several outpatient medical treatments) and grade IV (requiring hospitalisation). In total, 217 injuries were reported in detail. 125 injuries (58%) occurred in full contact and 92 (42%) in semi-contact karate. The time related injury rate of full contact karateka was 1.9/1000 h compared to 1.3/1000 h of semi-contact karateka (p injuries were musculoskeletal contusions (33% full contact, 20% semi-contact), followed by articular sprains with 19% and 16%. The lower extremity was affected twice as often in full contact (40%) as in semi-contact (20%) karate. Training injuries were reported by 80% of the full contact and 77% of the semi-contact karateka. Most injuries, both in training and competition, occurred in kumite. 75% of the reported injuries of full contact and 70% of semi-contact karateka were classified as low grade (I or II). The high rate of injuries during training and kumite (sparring) points to specific prevention goals. The emphasis should be put on proprioceptive training and consistent warm-up. In the actual competition the referees play a vital role regarding prevention. © Georg Thieme Verlag KG Stuttgart · New York.

Levosimendan no tratamento da contusão miocárdica grave pós-trauma torácico fechado: relato de caso = Levosimendan treatment for severe myocardial contusion after blunt chest trauma: case report

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Benincasa, Cristian Chassot

2007-01-01

Conclusão: na literatura existem dados que indicam a utilização de levosimendan na insuficiência cardíaca descompensada. Estudos experimentais e pequenos ensaios clínicos tem despertado o interesse na utilização de levosimendan para melhora da função miocárdica em pacientes com cardiopatia isquêmica, choque cardiogênico e choque séptico. Porém, ainda não há relatos sobre a sua utilização em contusão miocárdica

Altered sleep composition after traumatic brain injury does not affect declarative sleep-dependent memory consolidation

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Janna eMantua

2015-06-01

Full Text Available Individuals with a history of traumatic brain injury (TBI often report sleep disturbances, which may be caused by changes in sleep architecture or reduced sleep quality (greater time awake after sleep onset, poorer sleep efficiency, and sleep stage proportion alterations. Sleep is beneficial for memory formation, and herein we examine whether altered sleep physiology following TBI has deleterious effects on sleep-dependent declarative memory consolidation. Participants learned a list of word pairs in the morning or evening, and recall was assessed 12-hrs later, following an interval awake or with overnight sleep. Young adult participants (18-22 yrs were assigned to one of four experimental groups: TBI Sleep (n=14, TBI Wake (n=12, non-TBI Sleep (n=15, non-TBI Wake (n=15. Each TBI participant was >1 yr post-injury. Sleep physiology was measured with polysomnography. Memory consolidation was assessed by comparing change in word-pair recall over 12-hr intersession intervals. The TBI group spent a significantly greater proportion of the night in SWS than the non-TBI group at the expense of NREM1. The TBI group also had marginally lower EEG delta power during SWS in the central region. Intersession changes in recall were greater for intervals with sleep than without sleep in both groups. However, despite abnormal sleep stage proportions for individuals with a TBI history, there was no difference in the intersession change in recall following sleep for the TBI and non-TBI groups. In both Sleep groups combined, there was a positive correlation between Intersession Change and the proportion of the night in NREM2 + SWS. Overall, sleep composition is altered following TBI but such deficits do not yield insufficiencies in sleep-dependent memory consolidation.

Traumatic aortic injury score (TRAINS): an easy and simple score for early detection of traumatic aortic injuries in major trauma patients with associated blunt chest trauma.

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Mosquera, Victor X; Marini, Milagros; Muñiz, Javier; Asorey-Veiga, Vanesa; Adrio-Nazar, Belen; Boix, Ricardo; Lopez-Perez, José M; Pradas-Montilla, Gonzalo; Cuenca, José J

2012-09-01

To develop a risk score based on physical examination and chest X-ray findings to rapidly identify major trauma patients at risk of acute traumatic aortic injury (ATAI). A multicenter retrospective study was conducted with 640 major trauma patients with associated blunt chest trauma classified into ATAI (aortic injury) and NATAI (no aortic injury) groups. The score data set included 76 consecutive ATAI and 304 NATAI patients from a single center, whereas the validation data set included 52 consecutive ATAI and 208 NATAI patients from three independent institutions. Bivariate analysis identified variables potentially influencing the presentation of aortic injury. Confirmed variables by logistic regression were assigned a score according to their corresponding beta coefficient which was rounded to the closest integer value (1-4). Predictors of aortic injury included widened mediastinum, hypotension less than 90 mmHg, long bone fracture, pulmonary contusion, left scapula fracture, hemothorax, and pelvic fracture. Area under receiver operating characteristic curve was 0.96. In the score data set, sensitivity was 93.42 %, specificity 85.85 %, Youden's index 0.79, positive likelihood ratio 6.60, and negative likelihood ratio 0.08. In the validation data set, sensitivity was 92.31 % and specificity 85.1 %. Given the relative infrequency of traumatic aortic injury, which often leads to missed or delayed diagnosis, application of our score has the potential to draw necessary clinical attention to the possibility of aortic injury, thus providing the chance of a prompt specific diagnostic and therapeutic management.

A prospective epidemiological study of injuries in four English professional football clubs.

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Hawkins, R D; Fuller, C W

1999-06-01

To define the causes of injuries to players in English professional football during competition and training. Lost time injuries to professional and youth players were prospectively recorded by physiotherapists at four English League clubs over the period 1994 to 1997. Data recorded included information related to the injury, date and place of occurrence, type of activity, and extrinsic Playing factors. In all, 67% of all injuries occurred during competition. The overall injury frequency rate (IFR) was 8.5 injuries/1000 hours, with the IFR during competitions (27.7) being significantly (p IFRs for youth players were found to increase over the second half of the season, whereas they decreased for professional players. There were no significant differences in IFRs for professional and youth players during training. There were significantly (p 41%), sprains (20%), and contusions (20%) represented the major types of injury. The thigh (23%), the ankle (17%), knee (14%), and lower leg (13%) represented the major locations of injury, with significantly (p 41% of all injuries. The overall level of injury to professional footballers has been showed to be around 1000 times higher times higher than for industrial occupations generally regarded as high risk. The high level of muscle strains, in particular, indicates possible weakness in fitness training programmes and use of warming up and cooling down procedures by clubs and the need for benchmarking players' levels of fitness and performance. Increasing levels of injury to youth players as a season progresses emphasizes the importance of controlling the exposure of young players to high levels of competition.

Glibenclamide reduces secondary brain damage after experimental traumatic brain injury.

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Zweckberger, K; Hackenberg, K; Jung, C S; Hertle, D N; Kiening, K L; Unterberg, A W; Sakowitz, O W

2014-07-11

Following traumatic brain injury (TBI) SUR1-regulated NCCa-ATP (SUR1/TRPM4) channels are transcriptionally up-regulated in ischemic astrocytes, neurons, and capillaries. ATP depletion results in depolarization and opening of the channel leading to cytotoxic edema. Glibenclamide is an inhibitor of SUR-1 and, thus, might prevent cytotoxic edema and secondary brain damage following TBI. Anesthetized adult Sprague-Dawley rats underwent parietal craniotomy and were subjected to controlled cortical impact injury (CCI). Glibenclamide was administered as a bolus injection 15min after CCI injury and continuously via osmotic pumps throughout 7days. In an acute trial (180min) mean arterial blood pressure, heart rate, intracranial pressure, encephalographic activity, and cerebral metabolism were monitored. Brain water content was assessed gravimetrically 24h after CCI injury and contusion volumes were measured by MRI scanning technique at 8h, 24h, 72h, and 7d post injury. Throughout the entire time of observation neurological function was quantified using the "beam-walking" test. Glibenclamide-treated animals showed a significant reduction in the development of brain tissue water content(80.47%±0.37% (glibenclamide) vs. 80.83%±0.44% (control); pbeam-walking test throughout 7days. In accordance to these results and the available literature, glibenclamide seems to have promising potency in the treatment of TBI. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

Don't Forget the Abdominal Wall: Imaging Spectrum of Abdominal Wall Injuries after Nonpenetrating Trauma.

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Matalon, Shanna A; Askari, Reza; Gates, Jonathan D; Patel, Ketan; Sodickson, Aaron D; Khurana, Bharti

2017-01-01

Abdominal wall injuries occur in nearly one of 10 patients coming to the emergency department after nonpenetrating trauma. Injuries range from minor, such as abdominal wall contusion, to severe, such as abdominal wall rupture with evisceration of abdominal contents. Examples of specific injuries that can be detected at cross-sectional imaging include abdominal muscle strain, tear, or hematoma, including rectus sheath hematoma (RSH); traumatic abdominal wall hernia (TAWH); and Morel-Lavallée lesion (MLL) (closed degloving injury). These injuries are often overlooked clinically because of (a) a lack of findings at physical examination or (b) distraction by more-severe associated injuries. However, these injuries are important to detect because they are highly associated with potentially grave visceral and vascular injuries, such as aortic injury, and because their detection can lead to the diagnosis of these more clinically important grave traumatic injuries. Failure to make a timely diagnosis can result in delayed complications, such as bowel hernia with potential for obstruction or strangulation, or misdiagnosis of an abdominal wall neoplasm. Groin injuries, such as athletic pubalgia, and inferior costochondral injuries should also be considered in patients with abdominal pain after nonpenetrating trauma, because these conditions may manifest with referred abdominal pain and are often included within the field of view at cross-sectional abdominal imaging. Radiologists must recognize and report acute abdominal wall injuries and their associated intra-abdominal pathologic conditions to allow appropriate and timely treatment. © RSNA, 2017.

Risk Factors for Pneumonia in Ventilated Trauma Patients with Multiple Rib Fractures

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Hyun Oh Park

2017-10-01

Full Text Available Background: Ventilator-associated pneumonia (VAP is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU. This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients. Trauma factors included sternal fracture, flail chest, diaphragm injury, traumatic aortic dissection, combined cardiac injury, pulmonary contusion, pneumothorax, hemothorax, hemopneumothorax, abbreviated injury scale score, thoracic trauma severity score, and injury severity score. Results: Forty-six patients (45.5% had at least 1 episode of VAP, 10 (21.7% of whom died in the ICU. Of the 55 (54.5% patients who did not have pneumonia, 9 (16.4% died in the ICU. Using logistic regression analysis, we found that VAP was associated with severe lung contusion (odds ratio, 3.07; 95% confidence interval, 1.12 to 8.39; p=0.029. Conclusion: Severe pulmonary contusion (pulmonary lung contusion score 6–12 is an independent risk factor for VAP in ventilated trauma patients with multiple rib fractures.

The treatment of acute soft tissue trauma in Danish emergency rooms

DEFF Research Database (Denmark)

Johannsen, F; Langberg, Henning

1997-01-01

Rest, ice, compression, elevation (RICE) is the most recommended treatment for acute traumatic soft tissue injuries. A questionnaire was given to all Danish emergency rooms (n = 5) regarding their routines for acute treatment of ankle sprains and muscle contusions. Complete answers were received...... from 37 emergency rooms (73%), covering the treatment of 111 ankle sprains and 101 muscle contusions. Treatment with RICE was given in a minority of injuries, ice (21%), compression (32%) and elevation (58%) similarly between injury types. A complete RICE treatment was rarely applied (3%). Verbal...... information on RICE and rehabilitation was given in less than half of the cases. We conclude that the acute treatment of ankle sprains and muscle contusions in the Danish emergency rooms is not applied in accordance with consensus from international literature, and that the instruction in rehabilitation...

Eye Injuries in High School and Collegiate Athletes.

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Boden, Barry P; Pierpoint, Lauren A; Boden, Rebecca G; Comstock, R Dawn; Kerr, Zachary Y

Although eye injuries constitute a small percentage of high school and college sports injuries, they have the potential to be permanently debilitating. Eye injury rates will vary by sport, sex, and between the high school and college age groups. Descriptive epidemiology study. Level 3. Data from eye injury reports in high school and college athletes were obtained from the National High School Sports-Related Injury Surveillance System, High School Reporting Information Online (HS RIO) database over a 10-year span (2005-2006 through 2014-2015 school years) and the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP) over an 11-year span (2004-2005 through 2014-2015 school years). Injury rates per 100,000 athlete-exposures (AEs), injury rate ratios (RRs), and 95% CIs were calculated. Distributions of eye injuries by diagnosis, mechanism, time loss, and surgery needs were also examined. A total of 237 and 273 eye injuries were reported in the HS RIO and the NCAA ISP databases, respectively. The sports with the highest eye injury rates (per 100,000 AEs) for combined high school and college athletes were women's basketball (2.36), women's field hockey (2.35), men's basketball (2.31), and men's wrestling (2.07). Overall eye injury rates at the high school and college levels were 0.68 and 1.84 per 100,000 AEs, respectively. Eye injury rates were higher in competition than practice in high school (RR, 3.47; 95% CI, 2.69-4.48) and college (RR, 3.13; 95% CI, 2.45-3.99). Most injuries were contusions (high school, 35.9%; college, 33.3%) and due to contact (high school, 89.9%; college, 86.4%). Only a small percentage of injuries resulted in time loss over 21 days (high school, 4.2%; college, 3.0%). Eye injury rates and patterns vary by sport, sex, and between the high school and college age groups. Although severe injuries do occur, most eye injuries sustained by high school and college athletes are minor, with limited time loss and full recovery

Epidemiology of injuries in elite taekwondo athletes: two Olympic periods cross-sectional retrospective study

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Altarriba-Bartes, Albert; Drobnic, Franchek; Til, Lluís; Malliaropoulos, Nikolaos; Montoro, José Bruno; Irurtia, Alfredo

2014-01-01

Objective Taekwondo injuries differ according to the characteristics of the athletes and the competition. This analytical cross-sectional retrospective cohort study aimed to describe reported taekwondo injuries and to determine the prevalence, characteristics and possible risk factors for injuries sustained by athletes of the Spanish national team. In addition, we compared each identified risk factor—age, weight category, annual quarter, injury timing and competition difficulty level—with its relation to injury location and type. Settings Injury occurrences in taekwondo athletes of the Spanish national team during two Olympic periods at the High Performance Centre in Barcelona were analysed. Participants 48 taekwondo athletes (22 male, 26 female; age range 15–31 years) were studied; 1678 injury episodes occurred. Inclusion criteria were: (1) having trained with the national taekwondo group for a minimum of one sports season; (2) being a member of the Spanish national team. Results Independently of sex or Olympic period, the anatomical sites with most injury episodes were knee (21.3%), foot (17.0%), ankle (12.2%), thigh (11.4%) and lower leg (8.8%). Contusions (29.3%) and cartilage (17.6%) and joint (15.7%) injuries were the prevalent types of injury. Chronological age, weight category and annual quarter can be considered risk factors for sustaining injuries in male and female elite taekwondists according to their location and type (p≤0.001). Conclusions This study provides epidemiological information that will help to inform future injury surveillance studies and the development of prevention strategies and recommendations to reduce the number of injuries in taekwondo competition. PMID:24531455

Comparative Effectiveness of Family Problem-Solving Therapy (F-PST) for Adolescent TBI

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2018-01-25

Tbi; Intracranial Edema; Brain Edema; Craniocerebral Trauma; Head Injury; Brain Hemorrhage, Traumatic; Subdural Hematoma; Brain Concussion; Head Injuries, Closed; Epidural Hematoma; Cortical Contusion; Wounds and Injuries; Disorders of Environmental Origin; Trauma, Nervous System; Brain Injuries

Decreased Secondary Lesion Growth and Attenuated Immune Response after Traumatic Brain Injury in Tlr2/4−/− Mice

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Sandro M. Krieg

2017-08-01

Full Text Available Danger-associated molecular patterns are released by damaged cells and trigger neuroinflammation through activation of non-specific pattern recognition receptors, e.g., toll-like receptors (TLRs. Since the role of TLR2 and 4 after traumatic brain injury (TBI is still unclear, we examined the outcome and the expression of pro-inflammatory mediators after experimental TBI in Tlr2/4−/− and wild-type (WT mice. Tlr2/4−/− and WT mice were subjected to controlled cortical injury and contusion volume and brain edema formation were assessed 24 h thereafter. Expression of inflammatory markers in brain tissue was measured by quantitative PCR 15 min, 3 h, 6 h, 12 h, and 24 h after controlled cortical impact (CCI. Contusion volume was significantly attenuated in Tlr2/4−/− mice (29.7 ± 0.7 mm3 as compared to 33.5 ± 0.8 mm3 in WT; p < 0.05 after CCI while brain edema was not affected. Only interleukin (IL-1β gene expression was increased after CCI in the Tlr2/4−/− relative to WT mice. Inducible nitric oxide synthetase, TNF, IL-6, and COX-2 were similar in injured WT and Tlr2/4−/− mice, while the increase in high-mobility group box 1 was attenuated at 6 h. TLR2 and 4 are consequently shown to potentially promote secondary brain injury after experimental CCI via neuroinflammation and may therefore represent a novel therapeutic target for the treatment of TBI.

Rapid recovery and altered neurochemical dependence of locomotor central pattern generation following lumbar neonatal spinal cord injury.

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Züchner, Mark; Kondratskaya, Elena; Sylte, Camilla B; Glover, Joel C; Boulland, Jean-Luc

2018-01-15

were two main locomotor frequencies, but injured spinal cords exhibited a shift towards the higher frequency. Injury also altered the neurochemical dependence of locomotor CPG output, such that injured spinal cords, unlike control spinal cords, were incapable of generating low frequency rhythmic coordinated activity in the presence of NMDA and dopamine alone. Thus, the neonatal spinal cord also exhibits remarkable functional recovery after lumbar injuries, but the neurochemical sensitivity of locomotor circuitry is modified in the process. © 2017 The Authors. The Journal of Physiology © 2017 The Physiological Society.

Injuries associated with combat sports, active component, U.S. Armed Forces, 2010-2013.

Science.gov (United States)

2014-05-01

The practice of combat sports creates a potential for training- and sports-related injuries among military members. During the 4-year surveillance period, there were 12,108 cases of injuries associated with combat sports among active component service members; the overall incidence rate was 21.0 per 10,000 person-years (p-yrs). The rates were higher among service members who were male, Hispanic, in the youngest age groups, in the Army, junior enlisted, and in combat-specific occupations. The rate among recruit/ trainees (779.4 per 10,000 p-yrs) was more than 165 times the rate among all other active component service members (non-recruits) (4.7 per 10,000 p-yrs). Sprains, strains, and contusions accounted for more than one-half of the primary (first-listed) diagnoses associated with combat sports cases. More serious conditions such as concussions/head injuries and skull/face fractures/intracranial injuries were reported among 3.9% and 2.1% of all cases and were more common among boxing-related cases. Hand/wrist fractures were also common among boxing cases. Wrestling had comparatively greater proportions of dislocations and open wounds. Although the combat sport training provides many physical and mental benefits to the individual, safety practices should be enforced to reduce the most frequent and serious injuries.

Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

International Nuclear Information System (INIS)

Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon; Bae, Sang Jin

2004-01-01

We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance (ρ > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury

Non-contiguous spinal injury in cervical spinal trauma: evaluation with cervical spine MRI

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Choi, Soo Jung; Shin, Myung Jin; Kim, Sung Moon [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Bae, Sang Jin [Sanggyepaik Hospital, Inje University, Seoul (Korea, Republic of)

2004-12-15

We wished to evaluate the incidence of non-contiguous spinal injury in the cervicothoracic junction (CTJ) or the upper thoracic spines on cervical spinal MR images in the patients with cervical spinal injuries. Seventy-five cervical spine MR imagings for acute cervical spinal injury were retrospectively reviewed (58 men and 17 women, mean age: 35.3, range: 18-81 years). They were divided into three groups based on the mechanism of injury; axial compression, hyperflexion or hyperextension injury, according to the findings on the MR and CT images. On cervical spine MR images, we evaluated the presence of non-contiguous spinal injury in the CTJ or upper thoracic spine with regard to the presence of marrow contusion or fracture, ligament injury, traumatic disc herniation and spinal cord injury. Twenty-one cases (28%) showed CTJ or upper thoracic spinal injuries (C7-T5) on cervical spinal MR images that were separated from the cervical spinal injuries. Seven of 21 cases revealed overt fractures in the CTJs or upper thoracic spines. Ligament injury in these regions was found in three cases. Traumatic disc herniation and spinal cord injury in these regions were shown in one and two cases, respectively. The incidence of the non-contiguous spinal injuries in CTJ or upper thoracic spines was higher in the axial compression injury group (35.5%) than in the hyperflexion injury group (26.9%) or the hyperextension (25%) injury group. However, there was no statistical significance ({rho} > 0.05). Cervical spinal MR revealed non-contiguous CTJ or upper thoracic spinal injuries in 28% of the patients with cervical spinal injury. The mechanism of cervical spinal injury did not significantly affect the incidence of the non-contiguous CTJ or upper thoracic spinal injury.

Prevalence and Clinical Import of Thoracic Injury Identified by Chest Computed Tomography but Not Chest Radiography in Blunt Trauma: Multicenter Prospective Cohort Study.

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Langdorf, Mark I; Medak, Anthony J; Hendey, Gregory W; Nishijima, Daniel K; Mower, William R; Raja, Ali S; Baumann, Brigitte M; Anglin, Deirdre R; Anderson, Craig L; Lotfipour, Shahram; Reed, Karin E; Zuabi, Nadia; Khan, Nooreen A; Bithell, Chelsey A; Rowther, Armaan A; Villar, Julian; Rodriguez, Robert M

2015-12-01

Chest computed tomography (CT) diagnoses more injuries than chest radiography, so-called occult injuries. Wide availability of chest CT has driven substantial increase in emergency department use, although the incidence and clinical significance of chest CT findings have not been fully described. We determine the frequency, severity, and clinical import of occult injury, as determined by changes in management. These data will better inform clinical decisions, need for chest CT, and odds of intervention. Our sample included prospective data (2009 to 2013) on 5,912 patients at 10 Level I trauma center EDs with both chest radiography and chest CT at physician discretion. These patients were 40.6% of 14,553 enrolled in the parent study who had either chest radiography or chest CT. Occult injuries were pneumothorax, hemothorax, sternal or greater than 2 rib fractures, pulmonary contusion, thoracic spine or scapula fracture, and diaphragm or great vessel injury found on chest CT but not on preceding chest radiography. A priori, we categorized thoracic injuries as major (having invasive procedures), minor (observation or inpatient pain control >24 hours), or of no clinical significance. Primary outcome was prevalence and proportion of occult injury with major interventions of chest tube, mechanical ventilation, or surgery. Secondary outcome was minor interventions of admission rate or observation hours because of occult injury. Two thousand forty-eight patients (34.6%) had chest injury on chest radiography or chest CT, whereas 1,454 of these patients (71.0%, 24.6% of all patients) had occult injury. Of these, in 954 patients (46.6% of injured, 16.1% of total), chest CT found injuries not observed on immediately preceding chest radiography. In 500 more patients (24.4% of injured patients, 8.5% of all patients), chest radiography found some injury, but chest CT found occult injury. Chest radiography found all injuries in only 29.0% of injured patients. Two hundred and two

[School accidents--an epidemiological assessment of injury types and treatment effort].

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Kraus, R; Heiss, C; Alt, V; Schnettler, R

2006-10-01

Children and adolescents spend up to 50% of their time at school. The purpose of this study was to assess injury patterns with their treatment of school accidents in a Trauma Service of a German University Hospital and to compare these data to the literature. All school accidents from 01.07.1999 to 30.06.2004 were statistically analysed in a retrospective manner by chart review. There were 1399 school accidents treated in our department. Average age of the injured children was 11.8 years with a boy:girl ratio of 3:2. Almost 40% of the injuries occurred during school sport. The most frequently injured region was the upper extremity including the hand (36.8%). Distortion and contusion were the most frequent diagnoses of all injuries. 16% of the cases had to be treated surgically and/or under general anaesthesia and also a total of 16% of the patients had to be admitted to the hospital. It can be concluded for school facilities that special attention has to be paid during school sports activity and breaks because they account for most accidents. Traffic education may reduce severe injuries. For diagnosis and treatment of school accidents specific knowledge of the growing longbones of the upper extremity and the hand is important.

Clinical features of the head injury caused by child abuse in infants

International Nuclear Information System (INIS)

Nishimoto, Hiroshi; Kurihara, Jun

2007-01-01

The diagnosis and managements of the head injury in battered children are greatly complicated by medical history and the mechanisms of injury. In the present study, we evaluated the clinical features of the head injury in battered children. Clinical signs and symptoms, the mechanisms of injury, intracranial pathology, and prognosis of 25 battered children with head injury treated between 1984 and 2003 were retrospectively analyzed. The age of 25 children was between 1 month and 2 years old. The average of the ages was 7 months old. In 68% of 25 patients, the age was 6 months or less. The medical history of head injury was unclear in 16 children. The chief complains were disturbance of consciousness, convulsion, vomiting and hypothermia. Retinal hemorrhages were recognized in 88% of the patients and these were bilateral in 68%. Acute subdural hematomas (19 cases) and chronic subdural hematomas (6 cases) were shown on CTs or MRIs. In four cases, cerebral contusions were complicated as intracranial pathology. In 44% of the patients, the hypoxic-ischemic injury was confirmed on CTs or MRIs. Fractures of limbs and ribs were recognized on skeletal survey in 40% of the patients. 71% of 17 survival cases had moderate or severe psychomotor disabilities at the end of follow-up periods. In children under 2 years of age with subdural hematomas, clinical investigations other than CT and MRI, included ophthalmoscopy by ophthalmologist and skeletal survey, are crucial and mandatory for early diagnosis of the child abuse. (author)

The management of complex pancreatic injuries.

Science.gov (United States)

Krige, J E J; Beningfield, S J; Nicol, A J; Navsaria, P

2005-08-01

Major injuries of the pancreas are uncommon, but may result in considerable morbidity and mortality because of the magnitude of associated vascular and duodenal injuries or underestimation of the extent of the pancreatic injury. Prognosis is influenced by the cause and complexity of the pancreatic injury, the amount of blood lost, duration of shock, speed of resuscitation and quality and nature of surgical intervention. Early mortality usually results from uncontrolled or massive bleeding due to associated vascular and adjacent organ injuries. Late mortality is a consequence of infection or multiple organ failure. Neglect of major pancreatic duct injury may lead to life-threatening complications including pseudocysts, fistulas, pancreatitis, sepsis and secondary haemorrhage. Careful operative assessment to determine the extent of gland damage and the likelihood of duct injury is usually sufficient to allow planning of further management. This strategy provides a simple approach to the management of pancreatic injuries regardless of the cause. Four situations are defined by the extent and site of injury: (i) minor lacerations, stabs or gunshot wounds of the superior or inferior border of the body or tail of the pancreas (i.e. remote from the main pancreatic duct), without visible duct involvement, are best managed by external drainage; (ii) major lacerations or gunshot or stab wounds in the body or tail with visible duct involvement or transection of more than half the width of the pancreas are treated by distal pancreatectomy; (iii) stab wounds, gunshot wounds and contusions of the head of the pancreas without devitalisation of pancreatic tissue are managed by external drainage, provided that any associated duodenal injury is amenable to simple repair; and (iv) non-reconstructable injuries with disruption of the ampullary-biliary-pancreatic union or major devitalising injuries of the pancreatic head and duodenum in stable patients are best treated by

Cardiogenic shock following blunt chest trauma

Directory of Open Access Journals (Sweden)

Rodríguez-González Fayna

2010-01-01

Full Text Available Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increased frequency over the past decades. Traffic accidents are the most frequent cause of cardiac contusions resulting from a direct blow to the chest. Other causes of blunt cardiac injury are numerous and include violent fall impacts, interpersonal aggression, explosions, and various types of high-risk sports. Myocardial contusion is difficult to diagnose; clinical presentation varies greatly, ranging from lack of symptoms to cardiogenic shock and arrhythmia. Although death is rare, cardiac contusion can be fatal. We present a case of cardiac contusion due to blunt chest trauma secondary to a fall impact, which manifested as cardiogenic shock.

[Skiing injuries in school sport and possibilioties to prevent them].

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Greier, K

2011-12-01

Tyrol (Austria) is one of the regions which pioneered skiing. Skiing is considered as a national sport and is deeply rooted within the school system. Thus most pupils partake in skiing courses in this period. It is clear that such a large group of pupils also leads to a significant number of skiing injuries. Preventive issues may be derived from an analysis of the pattern and circumstances of skiing injuries. During a period of ten years (2000 - 2009) 1522 school sports injuries have been reported to the health insurance agency (Allgemeine Unfallversicherungsanstalt) from all secondary schools in Tyrol. The major disciplines were ski (48 %, n = 734) ice skateing (23 %, n = 349) and snowboard injuries (21 %, n = 315), followed by tobogganing (6 %, n = 91), cross-country skiing (1 %, n = 17) and other wintersports (1 %, n = 16). Fractures (31 %) dominated in skiing, followed by contusions (23 %), and sprains (22 %). In the analysis of the distribution of injuries during alpine skiing accidents, lower extremity injuries (39 %) dominated followed by upper extremity injuries (34 %). Head and spine injuries (13 %) were rare. Analysing the circumstances of the injuries, most injuries during skiing occurred without person to person collision (82 %), 81 % either shortly before lunch-break or in the afternoon. Skiing injuries account for a significant proportion of all school sport-related injuries in Tyrol. Lower extremity injuries account for the vast majority of all injuries. Overestimation and overtiredness may be responsible for skiing sport injuries. Preventive measures such as a fitness training (e. g., skiing exercises) prior to skiing courses, appropriate breaks and proper protective gear (i. e., helmet and spine protector) may reduce the injury rate in skiing school sport. © Georg Thieme Verlag KG Stuttgart · New York.

The "swing-ding": a golf-related head injury in children.

Science.gov (United States)

Wang, Arthur; Cohen, Alan R; Robinson, Shenandoah

2011-01-01

In recent years there has been an increased incidence of golf-associated head injuries in children and adolescents. At the authors' institution, they have identified a unique pattern of head injury associated with a swinging golf club. In this study, the authors highlight the mechanism of this injury and report their experience treating it. The authors reviewed the database of Rainbow Babies and Children's Hospital Trauma Center and performed a retrospective analysis of golf injuries recorded over a 10-year period (January 2000-April 2010). They identified 13 children (9 boys and 4 girls) who sustained head injuries in golfing accidents. All patients were 10 years of age or younger. The medical charts were reviewed and follow-up interviews were conducted to better delineate the details of the injuries. Injuries included 13 depressed skull fractures, 7 epidural hematomas, and 1 cerebral contusion. All 13 patients sustained their injuries after being struck in the head by a golf club. Seven sustained injuries on the follow-through of the initial swing and 3 sustained injuries on the backswing. All but one patient required neurosurgical intervention. Five patients developed neurological sequelae. None of the children had prior experience with golf equipment. All but one injury occurred in the child's own backyard. There was no direct supervision by an adult in any of the cases. Golfing can lead to serious head injuries in children. The authors noticed a unique pattern of golf-related head injuries, previously not described, that they have termed the "swing-ding." This golf club-inflicted injury occurs when a child stands too close to a swinging golfer and is struck in the head, subsequently sustaining a comminuted depressed skull fracture in the frontal or temporal region, with or without further intracranial injury. The study suggests that a lack of adult supervision, minimal previous golf experience, and proximity of the child to the swinging golfer are all

Diet, age, and prior injury status differentially alter behavioral outcomes following concussion in rats.

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Mychasiuk, Richelle; Hehar, Harleen; van Waes, Linda; Esser, Michael J

2015-01-01

Mild traumatic brain injury (mTBI) or concussion affects a large portion of the population and although many of these individuals recover completely, a small subset of people experience lingering symptomology and poor outcomes. Little is known about the factors that affect individual susceptibility or resilience to poor outcomes after mTBI and there are currently no biomarkers to delineate mTBI diagnosis or prognosis. Based upon the growing literature associated with caloric intake and altered neurological aging and the ambiguous link between repetitive mTBI and progressive neurodegeneration, the current study was designed to examine the effect of a high fat diet (HFD), developmental age, and repetitive mTBI on behavioral outcomes following a mTBI. In addition, telomere length was examined before and after experimental mTBI. Sprague Dawley rats were maintained on a HFD or standard rat chow throughout life (including the prenatal period) and then experienced an mTBI/concussion at P30, P30 and P60, or only at P60. Behavioral outcomes were examined using a test battery that was administered between P61-P80 and included; beam-walking, open field, elevated plus maze, novel context mismatch, Morris water task, and forced swim task. Animals with a P30 mTBI often demonstrated lingering symptomology that was still present during testing at P80. Injuries at P30 and P60 rarely produced cumulative effects, and in some tests (i.e., beam walking), the first injury may have protected the brain from the second injury. Exposure to the high fat diet exacerbated many of the behavioral deficits associated with concussion. Finally, telomere length was shortened following mTBI and was influenced by the animal's dietary intake. Diet, age at the time of injury, and the number of prior concussion incidents differentially contribute to behavioral deficits and may help explain individual variations in susceptibility and resilience to poor outcomes following an mTBI. Copyright © 2014

A six year prospective study of the incidence and causes of head and neck injuries in international football.

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Fuller, C W; Junge, A; Dvorak, J

2005-08-01

To identify those risk factors that have the greatest impact on the incidence of head and neck injuries in international football. A case-control study of players sustaining head and neck injuries during 20 FIFA tournaments (men and women) from 1998 to 2004. Video recordings of incidents were used to identify a range of parameters associated with the incidents. Team physicians provided medical reports describing the nature of each injury. chi2 tests (pvideo sequences. The commonest injuries were contusions (53%), lacerations (20%), and concussions (11%). The incidence of all head and neck injuries was 12.5/1000 player hours (men 12.8, women 11.5) and 3.7 for lost-time injuries (men 3.5, women 4.1). The commonest causes of injury involved aerial challenges (55%) and the use of the upper extremity (33%) or head (30%). The unfair use of the upper extremity was significantly more likely to cause an injury than any other player action. Only one injury (a neck muscle strain) occurred as a result of heading the ball throughout the 20 tournaments equivalent to 0.05 injuries/1000 player hours. Players' actions most likely to cause a head or neck injury were the use of the upper extremity or the head but in the majority of cases these challenges were deemed to be fair and within the laws of the game.

Fast pitch softball injuries.

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Meyers, M C; Brown, B R; Bloom, J A

2001-01-01

The popularity of fast pitch softball in the US and throughout the world is well documented. Along with this popularity, there has been a concomitant increase in the number of injuries. Nearly 52% of cases qualify as major disabling injuries requiring 3 weeks or more of treatment and 2% require surgery. Interestingly, 75% of injuries occur during away games and approximately 31% of traumas occur during nonpositional and conditioning drills. Injuries range from contusions and tendinitis to ligamentous disorders and fractures. Although head and neck traumas account for 4 to 12% of cases, upper extremity traumas account for 23 to 47% of all injuries and up to 19% of cases involve the knee. Approximately 34 to 42% of injuries occur when the athlete collides with another individual or object. Other factors involved include the quality of playing surface, athlete's age and experience level, and the excessive physical demands associated with the sport. Nearly 24% of injuries involve base running and are due to poor judgement, sliding technique, current stationary base design, unorthodox joint and extremity position during ground impact and catching of cleats. The increasing prevalence of overtraining syndrome among athletes has been attributed to an unclear definition of an optimal training zone, poor communication between player and coach, and the limited ability of bone and connective tissue to quickly respond to match the demands of the sport. This has led routinely to arm, shoulder and lumbar instability, chronic nonsteroidal anti-inflammatory drug (NSAID) use and time loss injuries in 45% of pitching staff during a single season. Specific attention to a safer playing environment, coaching and player education, and sport-specific training and conditioning would reduce the risk, rate and severity of fast pitch traumas. Padding of walls, backstops, rails and dugout areas, as well as minimising use of indoor facilities, is suggested to decrease the number of collision

Curcumin pretreatment attenuates brain lesion size and improves neurological function following traumatic brain injury in the rat.

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Samini, Fariborz; Samarghandian, Saeed; Borji, Abasalt; Mohammadi, Gholamreza; bakaian, Mahdi

2013-09-01

Turmeric has been in use since ancient times as a condiment and due to its medicinal properties. Curcumin, the yellow coloring principle in turmeric, is a polyphenolic and a major active constituent. Besides anti-inflammatory, thrombolytic and anti-carcinogenic activities, curcumin also possesses strong antioxidant property. The neuroprotective effects of curcumin were evaluated in a weight drop model of cortical contusion trauma in rat. Male Wistar rats (350-400 g, n=9) were anesthetized with sodium pentobarbital (60 mg/kg i.p.) and subjected to head injury. Five days before injury, animals randomly received an i.p. bolus of either curcumin (50 and 100 mg/kg/day, n=9) or vehicle (n=9). Two weeks after the injury and drug treatment, animals were sacrificed and a series of brain sections, stained with hematoxylin and eosin (H&E) were evaluated for quantitative brain lesion volume. Two weeks after the injury, oxidative stress parameter (malondialdehyde) was also measured in the brain. Curcumin (100 mg/kg) significantly reduced the size of brain injury-induced lesions (Pcurcumin (100 mg/kg). Curcumin treatment significantly improved the neurological status evaluated during 2 weeks after brain injury. The study demonstrates the protective efficacy of curcumin in rat traumatic brain injury model. © 2013 Elsevier Inc. All rights reserved.

Blunt thoracic trauma and cardiac injury in the athlete: contemporary management.

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DE Gregorio, Cesare; Magaudda, Ludovico

2017-09-29

Commotion cordis and cardiac injuries are rare events usually following a chest blunt trauma during sports activities. Various aetiologies have been identified to cause electrical (commotion cordis) and/or structural (contusion and further injuries) damage, but high-velocity tools such as baseballs or hockey pucks (also called projectiles) have been chiefly identified. Clinical consequences are challenging, varying from uncomplicated supraventricular arrhythmias to cardiac wall rupture. Ventricular fibrillation is the most remarkable outcome leading to cardiac arrest in some individuals. In this article, up-to-date epidemiological and pathophysiological issues are discussed, along with the most suitable assistance protocols of the injured athlete in the sports arena. Current knowledge about traumatic sports injuries and ensuing cardiovascular sequelae made significant steps forwards than in the past. The majority of athletes (especially the youngest ones) wearing chest protectors are usually preserved from serious outcomes and sudden cardiac death, but further technical effort is encouraged to attain more satisfactory barriers against projectile's impact. Educational campaigns among students, closer team surveillance, implementation of the sports arenas with adequate rescue devices and medical assistance remain mandatory in every sports activity.

Traumatic Brain Injury in Qatar: Age Matters—Insights from a 4-Year Observational Study

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Moamena El-Matbouly

2013-01-01

Full Text Available Background. Overall traumatic brain injury (TBI incidence and related death rates vary across different age groups. Objectives. To evaluate the incidence, causes, and outcome of TBI in adolescents and young adult population in Qatar. Method. This was a retrospective review of all TBIs admitted to the trauma center between January 2008 and December 2011. Demographics, mechanism of injury, morbidity, and mortality were analyzed in different age groups. Results. A total of 1665 patients with TBI were admitted; the majority were males (92% with a mean age of 28 ± 16 years. The common mechanism of injury was motor vehicle crashes and falls from height (51% and 35%, resp.. TBI was incidentally higher in young adults (34% and middle age group (21%. The most frequent injuries were contusion (40%, subarachnoid (25%, subdural (24%, and epidural hemorrhage (18%. The mortality rate was 11% among TBI patients. Mortality rates were 8% and 12% among adolescents and young adults, respectively. The highest mortality rate was observed in elderly patients (35%. Head AIS, ISS, and age were independent predictors for mortality. Conclusion. Adolescents and adults sustain significant portions of TBI, whereas mortality is much higher in the older group. Public awareness and injury prevention campaigns should target young population.

Skateboarding injuries in Vienna: location, frequency, and severity.

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Keilani, Mohammad; Krall, Christoph; Lipowec, Lucas; Posch, Martin; Komanadj, Tanya Sedghi; Crevenna, Richard

2010-07-01

To describe injury patterns of skateboard-associated injuries (SAIs) and to assess the frequency and severity of SAIs depending on an athlete's skateboarding experience. Cross-sectional observation. Skating areas. A total of 100 Viennese skateboarders. No intervention. The participants filled in a questionnaire that was used to assess selected sociodemographic data; duration and frequency of skateboarding; "stance"; and localization, rate, as well as the severity of SAIs during the past 24 months. Skating behavior and sociodemographic data were compared with frequency and severity of SAIs. Response rate of questionnaires was 75% (n=75) of the participants. Duration of skateboarding was 8+/-5 years, and training time was 18+/-11 hours/week. A total of 97% (73) of the respondents reported at least one injury: in 52% (39) of the respondents the most serious injury was mild to moderate (laceration, contusion, strain/sprain, and bruise), whereas in 45% (34) it was severe (ligament rupture, fracture). A total of 33% (13) of participants experiencing only mild-to-moderate injuries consulted a physician compared with 94% (32) with at least one serious injury. The most severely affected regions were lower leg/ankle/foot in 32% (24) of all respondents who experienced at least one severe injury and forearm/wrist/hand in 16% (12) who experienced at least one severe injury. Only 13% (10) used protective equipment. Multivariate logistic regression for the occurrence of at least one severe injury with all socioeconomic and sport-relevant data investigated revealed significant positive correlations with weekly training time (P=.037) and years of experience (P=.021). However, after correcting for multiple testing (Bonferroni adjustment for 8 tests), no significances remained. More experienced skateboarders seem to have a greater risk of incurring severe SAIs, but sociodemographic factors seem to have no influence on injury risk in this population. Only a minority of skateboarders

Neural progenitor cells but not astrocytes respond distally to thoracic spinal cord injury in rat models

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Tara Nguyen

2017-01-01

Full Text Available Traumatic spinal cord injury (SCI is a detrimental condition that causes loss of sensory and motor function in an individual. Many complex secondary injury cascades occur after SCI and they offer great potential for therapeutic targeting. In this study, we investigated the response of endogenous neural progenitor cells, astrocytes, and microglia to a localized thoracic SCI throughout the neuroaxis. Twenty-five adult female Sprague-Dawley rats underwent mild-contusion thoracic SCI (n = 9, sham surgery (n = 8, or no surgery (n = 8. Spinal cord and brain tissues were fixed and cut at six regions of the neuroaxis. Immunohistochemistry showed increased reactivity of neural progenitor cell marker nestin in the central canal at all levels of the spinal cord. Increased reactivity of astrocyte-specific marker glial fibrillary acidic protein was found only at the lesion epicenter. The number of activated microglia was significantly increased at the lesion site, and activated microglia extended to the lumbar enlargement. Phagocytic microglia and macrophages were significantly increased only at the lesion site. There were no changes in nestin, glial fibrillary acidic protein, microglia and macrophage response in the third ventricle of rats subjected to mild-contusion thoracic SCI compared to the sham surgery or no surgery. These findings indicate that neural progenitor cells, astrocytes and microglia respond differently to a localized SCI, presumably due to differences in inflammatory signaling. These different cellular responses may have implications in the way that neural progenitor cells can be manipulated for neuroregeneration after SCI. This needs to be further investigated.

Non-concomitant cortical structural and functional alterations in sensorimotor areas following incomplete spinal cord injury

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Yu Pan

2017-01-01

Full Text Available Brain plasticity, including anatomical changes and functional reorganization, is the physiological basis of functional recovery after spinal cord injury (SCI. The correlation between brain anatomical changes and functional reorganization after SCI is unclear. This study aimed to explore whether alterations of cortical structure and network function are concomitant in sensorimotor areas after incomplete SCI. Eighteen patients with incomplete SCI (mean age 40.94 ± 14.10 years old; male:female, 7:11 and 18 healthy subjects (37.33 ± 11.79 years old; male:female, 7:11 were studied by resting state functional magnetic resonance imaging. Gray matter volume (GMV and functional connectivity were used to evaluate cortical structure and network function, respectively. There was no significant alteration of GMV in sensorimotor areas in patients with incomplete SCI compared with healthy subjects. Intra-hemispheric functional connectivity between left primary somatosensory cortex (BA1 and left primary motor cortex (BA4, and left BA1 and left somatosensory association cortex (BA5 was decreased, as well as inter-hemispheric functional connectivity between left BA1 and right BA4, left BA1 and right BA5, and left BA4 and right BA5 in patients with SCI. Functional connectivity between both BA4 areas was also decreased. The decreased functional connectivity between the left BA1 and the right BA4 positively correlated with American Spinal Injury Association sensory score in SCI patients. The results indicate that alterations of cortical anatomical structure and network functional connectivity in sensorimotor areas were non-concomitant in patients with incomplete SCI, indicating the network functional changes in sensorimotor areas may not be dependent on anatomic structure. The strength of functional connectivity within sensorimotor areas could serve as a potential imaging biomarker for assessment and prediction of sensory function in patients with incomplete SCI

Epidemiology of competition injuries in youth karate athletes: a prospective cohort study.

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Čierna, Dušana; Lystad, Reidar P

2017-09-01

To determine the injury incidence rate and injury pattern among youth karate athletes competing in national tournaments in Slovakia, and to identify risk factors for injury. Data were collected at nine national youth karate tournaments in Slovakia in 2015 and 2016. Injury incidence rates were calculated per 1000 athlete-exposures (IIR AE ) and per 1000 min of exposure (IIR ME ) with 95% CIs. Subgroups were compared by calculating their rate ratios (RR) with 95% CIs. The overall IIR AE and IIR ME were 45.3 (95% CI 38.7 to 52.6) and 35.9 (95% CI 30.7 to 41.7), respectively. The most frequently injured anatomical region was the head/neck (57%), while the most common type of injury was contusion (85%). The risk of injury for the 12-17-year-old age group was almost twice that of the 6-12-year-old age group, after accounting for exposure time (RR ME 1.92 (95% CI 1.39 to 2.65)), and the difference was more pronounced for girls than boys (RR ME 2.47 (95% CI 1.52 to 4.00) vs RR ME 1.62 (95% CI 1.06 to 2.49), respectively). Youth karate has a relatively large proportion of head injuries. Adolescent and female youth karate athletes are at higher risk of injury compared with their child and male counterparts. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Determining the Prevalence and Assessing the Severity of Injuries in Mixed Martial Arts Athletes

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2009-01-01

Background Mixed martial arts (MMA) is currently the fastest growing sport in the United States and has recently surpassed boxing as the most popular full contact sport. Due to the physical nature of the sport, MMA is associated with various types of injuries. Objective The purpose of this study was aimed at identifying prevalence and assessing the severity, location, and type of injuries in MMA athletes sustained during MMA related activities in the twelve month period prior to the survey. Methods A total of fifty-five subjects between the ages of 18 to 39 participated in the study. Participants were given a two-part questionnaire to collect demographic and injury data. Results Two hundred seven injuries were reported in the study. Low belt ranks had significantly more injuries more than any other belt rank, resulting in more than two times higher injury rate. Professional fighters had significantly more injuries than amateur fighters, resulting in three times higher injury rate. The most common body region injured was the head/neck/face (38.2%), followed by the lower extremities (30.4%), upper extremities (22.7%), torso (8.2%), and groin (0.5%). Injuries to the nose (6.3%), shoulder (6.3%), and toe (6.3%) were the most common. The most common type of injury was contusions (29.4%), followed by strains (16.2%), sprains (14.9%), and abrasions (10.1%). Conclusion Injury prevention efforts should consider the prevalence and distribution of injuries and focus on reducing or preventing injuries to the head/neck/face in MMA related activities. Preventative measures should focus on improving protective equipment during training, and possible competition rule modifications to further minimize participant injury. PMID:21509103

A theoretical framework for understanding neuromuscular response to lower extremity joint injury.

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Pietrosimone, Brian G; McLeod, Michelle M; Lepley, Adam S

2012-01-01

Neuromuscular alterations are common following lower extremity joint injury and often lead to decreased function and disability. These neuromuscular alterations manifest in inhibition or abnormal facilitation of the uninjured musculature surrounding an injured joint. Unfortunately, these neural alterations are poorly understood, which may affect clinical recognition and treatment of these injuries. Understanding how these neural alterations affect physical function may be important for proper clinical management of lower extremity joint injuries. Pertinent articles focusing on neuromuscular consequences and treatment of knee and ankle injuries were collected from peer-reviewed sources available on the Web of Science and Medline databases from 1975 through 2010. A theoretical model to illustrate potential relationships between neural alterations and clinical impairments was constructed from the current literature. Lower extremity joint injury affects upstream cortical and spinal reflexive excitability pathways as well as downstream muscle function and overall physical performance. Treatment targeting the central nervous system provides an alternate means of treating joint injury that may be effective for patients with neuromuscular alterations. Disability is common following joint injury. There is mounting evidence that alterations in the central nervous system may relate to clinical changes in biomechanics that may predispose patients to further injury, and novel clinical interventions that target neural alterations may improve therapeutic outcomes.

Characterization of American Football Injuries in Children and Adolescents.

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Smith, Patrick J; Hollins, Anthony M; Sawyer, Jeffrey R; Spence, David D; Outlaw, Shane; Kelly, Derek M

2018-02-01

As a collision sport, football carries a significant risk of injury, as indicated by the large number of pediatric football-related injuries seen in emergency departments. There is little information in the medical literature focusing on the age-related injury patterns of this sport. Our purpose was to evaluate the types of football-related injuries that occur in children and adolescents and assess which patient characteristics, if any, affect injury pattern. Retrospective chart review was performed of football-related injuries treated at a level 1 pediatric referral hospital emergency department and surrounding urgent care clinics between January 2010 and January 2014. Patients with e-codes for tackle football selected from the electronic medical record were divided into 4 age groups: younger than 8 years old, 8 to 11, 12 to 14, and 15 to 18 years. Data collected included diagnosis codes, procedure codes, and hospital admission status. Review identified 1494 patients with 1664 football-related injuries, including 596 appendicular skeleton fractures, 310 sprains, 335 contusions, 170 closed head injuries, 62 dislocations, 9 spinal cord injuries, and 14 solid organ injuries. There were 646 (43.2%) athletes with upper extremity injuries and 487 (32.6%) with injuries to the lower extremity. Hospital admissions were required in 109 (7.3%) patients. Fracture was the most common injury in all four patient age groups, but occurred at a lower rate in the 15 to 18 years old age group. The rate of soft tissue injury was higher in the 15 to 18 years old age group. The rate of closed head injury, which included concussions, was highest in the younger than 8 years old age group. Age does influence the rates of certain football-related injuries in children and adolescents. Fractures decrease with increasing age, while the rate of soft tissue trauma increases with increasing age. Younger patients (younger than 8 y old) trended toward higher rates of closed head injury compared

Injuries at a Canadian National Taekwondo Championships: a prospective study

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Pieter Willy

2004-07-01

Full Text Available Abstract Background The purpose of this prospective study was to assess the injury rates in male and female adult Canadian Taekwondo athletes relative to total number of injuries, type and body part injured. Methods Subjects (219 males, 99 females participated in the 1997 Canadian National Taekwondo Championships in Toronto, Canada. Injuries were recorded on an injury form to documents any injury seen and treatment provided by the health care team. These data were later used for this study. The injury form describes the athlete and nature, site, severity and mechanism of the injury. Results The overall rate of injuries was 62.9/1,000 athlete-exposures (A-E. The males (79.9/1,000 A-E sustained significantly more injuries than the females (25.3/1,000 A-E. The lower extremities were the most commonly injured body region in the men (32.0 /1,000 A-E, followed by the head and neck (18.3/1,000 A-E. Injuries to the spine (neck, upper back, low back and coccyx were the third most often injured body region in males (13.8/1,000 A-E. All injuries to the women were sustained to the lower extremities. The most common type of injury in women was the contusion (15.2/1,000 A-E. However, men's most common type of injury was the sprain (22.8/1,000 A-E followed by joint dysfunction (13.7/1,000A-E. Concussions were only reported in males (6.9/1,000 A-E. Compared to international counterparts, the Canadian men and women recorded lower total injury rates. However, the males incurred more cerebral concussions than their American colleagues (4.7/1,000 A-E. Conclusions Similar to what was found in previous studies, the current investigation seems to suggest that areas of particular concern for preventive measures involve the head and neck as well as the lower extremities. This is the first paper to identify spinal joint dysfunction.

Injury profile of a professional soccer team in the premier league of iran.

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Hassabi, Mohammad; Mohammad-Javad Mortazavi, Seyed; Giti, Mohammad-Reza; Hassabi, Majid; Mansournia, Mohammad-Ali; Shapouran, Sara

2010-12-01

Despite numerous studies which have been done regarding soccer injuries worldwide, there is lack of available data considering the epidemiology of injuries in the Iranian soccer premier league, although it is the most popular sport in the country. The main goal of this research was to determine the incidence of physical injuries in the studied population, considering other characteristics such as site, type and mechanism as well. Twenty one adult male professional soccer players (age 24±3), members of a team (Tehran-Pas) participating in Iranian premier league, were followed during a 4-month period. The injury characteristics and exposure times were recorded by the team physician during all the matches and training sessions. The total exposure time was 2610 playing hours (2352 h of training versus 258 h of competition). Eighty six percent of the injuries were acute. Incidence of acute injuries was 16.5 (95% CI: 12-22) per 1000 hours of playing (11.5 per 1000 hrs of training and 62 per 1000 hrs of competition). The most common types of injuries were strains followed by contusions, each of which constituted 30% of acute injuries. More than 80% of injuries occurred in lower limbs, especially in thigh and groin regions. Nearly 60% of acute injuries occurred in dominant side of the body, and collision was the reason of about half of the acute injuries. Severity of more than 70% of the injuries was minor. On average each injury had led the player being off the field for about 10 days. The incidence of injury in this research is in range of numbers obtained in important international tournaments but the rate of injuries during training sessions is higher than comparable studies.

Magnetic resonance imaging evaluation of traumatic muscle injuries; Avaliacao por ressonancia magnetica das injurias musculares traumaticas

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Dias, Elisa Pompeu [Santa Casa de Misericordia do Rio de Janeiro, RJ (Brazil); Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia; Coutinho Junior, Antonio Carlos; Domingues, Romulo Cortes; Domingues, Romeu Cortes [Centro Medico Barrashopping, Rio de Janeiro, RJ (Brazil). Clinica de Diagnostico por Imagem (CDPI)

2001-12-01

We evaluated 43 magnetic resonance scans of the leg or thigh of patients suffering from sports trauma. Strains were the most frequent lesions observed. These lesions presented iso- or hypointense signal on T1 and hyperintense signal on T2 images, and were classified according to the intensity of the injury of the fibers into grades 1, 2 and 3. The second most common lesions in these series were contusions that appeared iso- or hypointense on T1 and hyperintense on T2 images. Fibrosis was also observed as low signal lesions on T1 and T2 images. (author)

Injuries Associated with Hoverboard Use: A Case Series of Emergency Department Patients

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Gregory S. Weingart

2017-09-01

Full Text Available Introduction: Since hoverboards became available in 2015, 2.5 million have been sold in the US. An increasing number of injuries related to their use have been reported, with limited data on associated injury patterns. We describe a case series of emergency department (ED visits for hoverboard-related injuries. Methods: We performed a retrospective chart review on patients presenting to 10 EDs in southeastern Virginia from December 24, 2015, through June 30, 2016. We used a free-text search feature of the electronic medical record to identify patients documented to have the word “hoverboard” in the record. We reported descriptive statistics for patient demographics, types of injuries, body injury location, documented helmet use, injury severity score (ISS, length of stay in the ED, and ED charges. Results: We identified 83 patients in our study. The average age was 26 years old (18 months to 78 years. Of these patients, 53% were adults; the majority were female (61.4% and African American (56.6%. The primary cause of injury was falls (91%, with an average ISS of 5.4 (0–10. The majority of injuries were contusions (37.3% and fractures (36.1%. Pediatric patients tended to have more fractures than adults (46.2% vs 27.3%. Though 20% of patients had head injuries, only one patient reported using a helmet. The mean and median ED charges were $2,292.00 (SD $1,363.64 and $1,808.00, respectively. Head injuries resulted in a significantly higher cost when compared to other injuries; median cost was $2,846.00. Conclusion: While the overall ISS was low, more pediatric patients suffered fractures compared to adults. Documented helmet use was low, yet 20% of our population had head injuries. Further investigation into proper protective gear and training is warranted.

Alterations of parenchymal microstructure, neuronal connectivity and cerebrovascular resistance at adolescence following mild to moderate traumatic brain injury in early development.

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Parent, Maxime; Li, Ying; Santhakumar, Vijayalakshmi; Hyder, Fahmeed; Sanganahalli, Basavaraju G; Kannurpatti, Sridhar

2018-06-01

TBI is a leading cause of morbidity in children. To investigate outcome of early developmental TBI during adolescence, a rat model of fluid percussion injury was developed, where previous work reported deficits in sensorimotor behavior and cortical blood flow at adolescence. 1 Based on the non-localized outcome, we hypothesized that multiple neurophysiological components of brain function, namely neuronal connectivity, synapse/axonal microstructural integrity and neurovascular function are altered and magnetic resonance imaging (MRI) methods could be used to determine regional alterations. Adolescent outcomes of developmental TBI were studied 2-months after injury, using functional MRI (fMRI) and Diffusion Tensor Imaging (DTI). fMRI based resting state functional connectivity (RSFC), representing neural connectivity, was significantly altered between sham and TBI. RSFC strength decreased in the cortex, hippocampus and thalamus accompanied by decrease in the spatial extent of their corresponding RSFC networks and inter-hemispheric asymmetry. Cerebrovascular reactivity to arterial CO2 changes diminished after TBI across both hemispheres, with a more pronounced decrease in the ipsilateral hippocampus, thalamus and motor cortex. DTI measures of fractional anisotropy (FA) and apparent diffusion coefficient (ADC), reporting on axonal and microstructural integrity of the brain, indicated similar inter-hemispheric asymmetry, with highest change in the ipsilateral hippocampus and regions adjoining the ipsilateral thalamus, hypothalamus and amygdala. TBI-induced corpus callosal microstructural alterations indicated measurable changes in inter-hemispheric structural connectivity. Hippocampus, thalamus and select cortical regions were most consistently affected in multiple imaging markers. The multi-modal MRI results demonstrate cortical and subcortical alterations in neural connectivity, cerebrovascular resistance and parenchymal microstructure in the adolescent brain

Isoflurane exerts neuroprotective actions at or near the time of severe traumatic brain injury.

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Statler, Kimberly D; Alexander, Henry; Vagni, Vincent; Holubkov, Richard; Dixon, C Edward; Clark, Robert S B; Jenkins, Larry; Kochanek, Patrick M

2006-03-03

Isoflurane improves outcome vs. fentanyl anesthesia, in experimental traumatic brain injury (TBI). We assessed the temporal profile of isoflurane neuroprotection and tested whether isoflurane confers benefit at the time of TBI. Adult, male rats were randomized to isoflurane (1%) or fentanyl (10 mcg/kg iv bolus then 50 mcg/kg/h) for 30 min pre-TBI. Anesthesia was discontinued, rats recovered to tail pinch, and TBI was delivered by controlled cortical impact. Immediately post-TBI, rats were randomized to 1 h of isoflurane, fentanyl, or no additional anesthesia, creating 6 anesthetic groups (isoflurane:isoflurane, isoflurane:fentanyl, isoflurane:none, fentanyl:isoflurane, fentanyl:fentanyl, fentanyl:none). Beam balance, beam walking, and Morris water maze (MWM) performances were assessed over post-trauma d1-20. Contusion volume and hippocampal survival were assessed on d21. Rats receiving isoflurane pre- and post-TBI exhibited better beam walking and MWM performances than rats treated with fentanyl pre- and any treatment post-TBI. All rats pretreated with isoflurane had better CA3 neuronal survival than rats receiving fentanyl pre- and post-TBI. In rats pretreated with fentanyl, post-traumatic isoflurane failed to affect function but improved CA3 neuronal survival vs. rats given fentanyl pre- and post-TBI. Post-traumatic isoflurane did not alter histopathological outcomes in rats pretreated with isoflurane. Rats receiving fentanyl pre- and post-TBI had the worst CA1 neuronal survival of all groups. Our data support isoflurane neuroprotection, even when used at the lowest feasible level before TBI (i.e., when discontinued with recovery to tail pinch immediately before injury). Investigators using isoflurane must consider its beneficial effects in the design and interpretation of experimental TBI research.

Prognostic models for predicting posttraumatic seizures during acute hospitalization, and at 1 and 2 years following traumatic brain injury.

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Ritter, Anne C; Wagner, Amy K; Szaflarski, Jerzy P; Brooks, Maria M; Zafonte, Ross D; Pugh, Mary Jo V; Fabio, Anthony; Hammond, Flora M; Dreer, Laura E; Bushnik, Tamara; Walker, William C; Brown, Allen W; Johnson-Greene, Doug; Shea, Timothy; Krellman, Jason W; Rosenthal, Joseph A

2016-09-01

Posttraumatic seizures (PTS) are well-recognized acute and chronic complications of traumatic brain injury (TBI). Risk factors have been identified, but considerable variability in who develops PTS remains. Existing PTS prognostic models are not widely adopted for clinical use and do not reflect current trends in injury, diagnosis, or care. We aimed to develop and internally validate preliminary prognostic regression models to predict PTS during acute care hospitalization, and at year 1 and year 2 postinjury. Prognostic models predicting PTS during acute care hospitalization and year 1 and year 2 post-injury were developed using a recent (2011-2014) cohort from the TBI Model Systems National Database. Potential PTS predictors were selected based on previous literature and biologic plausibility. Bivariable logistic regression identified variables with a p-value models. Multivariable logistic regression modeling with backward-stepwise elimination was used to determine reduced prognostic models and to internally validate using 1,000 bootstrap samples. Fit statistics were calculated, correcting for overfitting (optimism). The prognostic models identified sex, craniotomy, contusion load, and pre-injury limitation in learning/remembering/concentrating as significant PTS predictors during acute hospitalization. Significant predictors of PTS at year 1 were subdural hematoma (SDH), contusion load, craniotomy, craniectomy, seizure during acute hospitalization, duration of posttraumatic amnesia, preinjury mental health treatment/psychiatric hospitalization, and preinjury incarceration. Year 2 significant predictors were similar to those of year 1: SDH, intraparenchymal fragment, craniotomy, craniectomy, seizure during acute hospitalization, and preinjury incarceration. Corrected concordance (C) statistics were 0.599, 0.747, and 0.716 for acute hospitalization, year 1, and year 2 models, respectively. The prognostic model for PTS during acute hospitalization did not

MRI of cervical spine injuries complicating ankylosing spondylitis

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Koivikko, Mika P.; Koskinen, Seppo K. [Helsinki Medical Imaging Center, Helsinki University Central Hospital, Toeoeloe Hospital, Department of Radiology, Helsinki (Finland)

2008-09-15

The objective was to study characteristic MRI findings in cervical spine fractures complicating ankylosing spondylitis (AS). Technical issues related to MRI are also addressed. A review of 6,774 consecutive cervical spine multidetector CT (MDCT) scans obtained during 6.2 years revealed 33 ankylosed spines studied for suspected acute cervical spine injury complicating AS. Of these, 20 patients also underwent MRI. On MRI, of these 20 patients, 19 had a total of 29 cervical and upper thoracic spine fractures. Of 20 transverse fractures traversing both anterior and posterior columns, 7 were transdiskal and exhibited less bone marrow edema than did those traversing vertebral bodies. One Jefferson's, 1 atlas posterior arch (Jefferson's on MDCT), 2 odontoid process, and 5 non-contiguous spinous process fractures were detectable. MRI showed 2 fractures that were undetected by MDCT, and conversely, MDCT detected 6 fractures not seen on MRI; 16 patients had spinal cord findings ranging from impingement and contusion to complete transection. Magnetic resonance imaging can visualize unstable fractures of the cervical and upper thoracic spine. Paravertebral hemorrhages and any ligamentous injuries should alert radiologists to seek transverse fractures. Multiple fractures are common and often complicated by spinal cord injuries. Diagnostic images can be obtained with a flexible multipurpose coil if the use of standard spine array coil is impossible due to a rigid collar or excessive kyphosis. (orig.)

Inflammatory and apoptotic alterations in serum and injured tissue after experimental polytrauma in mice: distinct early response compared with single trauma or "double-hit" injury.

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Weckbach, Sebastian; Hohmann, Christoph; Braumueller, Sonja; Denk, Stephanie; Klohs, Bettina; Stahel, Philip F; Gebhard, Florian; Huber-Lang, Markus S; Perl, Mario

2013-02-01

The exact alterations of the immune system after polytrauma leading to sepsis and multiple-organ failure are poorly understood. Thus, the early local and systemic inflammatory and apoptotic response was characterized in a new polytrauma model and compared with the alterations seen after single or combined injuries. Anesthetized C57BL/6 mice were subjected to either blunt bilateral chest trauma (Tx), closed head injury, right femur fracture including contralateral soft tissue injury, or a combination of injuries (PTx). After 2 hours or 6 hours, animals were sacrificed, and the systemic as well as the local pulmonary immune response (bronchoalveolar lavage [BAL]/plasma cytokines, lung myeloperoxidase [MPO] activity, and alveolocapillary barrier dysfunction) were evaluated along with lung/brain apoptosis (lung caspase 3 Western blotting, immunohistochemistry, and polymorphonuclear leukocytes [PMN] Annexin V). Hemoglobin, PO2 saturation, and pH did not differ between the experimental groups. Local BAL cytokines/chemokines were significantly increased in almost all groups, which included Tx. There was no further enhancement of this local inflammatory response in the lungs in case of PTx. At 2 hours, all groups except sham and closed head injury alone revealed an increased activity of lung MPO. However, 6 hours after injury, lung MPO remained increased only in the PTx group. Increased BAL protein levels were found, reflecting enhanced lung leakage in all groups with Tx 6 hours after trauma. Only after PTx was neutrophil apoptosis significantly decreased, whereas lung caspase 3 and plasma interleukin 6/keratinocyte chemoattractant (KC) were substantially increased. The combination of different injuries leads to an earlier systemic inflammatory response when compared with the single insults. Interestingly, only after PTx but not after single or double hits was lung apoptosis increased, and PMN apoptosis was decreased along with a prolonged presence of neutrophils in the

Plasma aldosterone and CT findings in head injury, especially in acute subdural hematoma

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Takahashi, Hideaki

1988-12-01

As we have already reported, an increase in the plasma aldosterone level was regulary found after severe head injury. And the values of plasma aldosterone in unconscious patients with increased intracranial pressure were significantly higher than those in patients without unconsciousness. Thus, plasma aldosterone in acute phase of head injury seems to be a sensitive index of increased intracranial pressure. In the present study, we measured plasma aldosterone levels in three groups ; subdural hematoma with mid-line shift (group A), cerebral contusion without mid-line shift (group B) and cerebral conceussion (group C). In group A, the peak value of aldosterone was markedly high (283.9 +- 142.5). In B, the peak value (143.7 +- 27.8) was higher than in C (116.3 +- 35.0). And, correlation between the serum aldosterone levels and CT findings, especially the mid-line shift was found. As a conclusion, the serum levels of aldosterone seems to be associated with intracranial pressure.

Alterations in the Timing of Huperzine A Cerebral Pharmacodynamics in the Acute Traumatic Brain Injury Setting.

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Damar, Ugur; Gersner, Roman; Johnstone, Joshua T; Kapur, Kush; Collins, Stephen; Schachter, Steven; Rotenberg, Alexander

2018-01-15

Traumatic brain injury (TBI) may affect the pharmacodynamics of centrally acting drugs. Paired-pulse transcranial magnetic stimulation (ppTMS) is a safe and noninvasive measure of cortical gamma-aminobutyric acid (GABA)-mediated cortical inhibition. Huperzine A (HupA) is a naturally occurring acetylcholinesterase inhibitor with newly discovered potent GABA-mediated antiepileptic capacity, which is reliably detected by ppTMS. To test whether TBI alters cerebral HupA pharmacodynamics, we exposed rats to fluid percussion injury (FPI) and tested whether ppTMS metrics of cortical inhibition differ in magnitude and temporal pattern in injured rats. Anesthetized adult rats were exposed to FPI or sham injury. Ninety minutes post-TBI, rats were injected with HupA or saline (0.6 mg/kg, intraperitoneally). TBI resulted in reduced cortical inhibition 90 min after the injury (N = 18) compared to sham (N = 13) controls (p = 0.03). HupA enhanced cortical inhibition after both sham injury (N = 6; p = 0.002) and TBI (N = 6; p = 0.02). The median time to maximum HupA inhibition in sham and TBI groups were 46.4 and 76.5 min, respectively (p = 0.03). This was consistent with a quadratic trend comparison that projects HupA-mediated cortical inhibition to last longer in injured rats (p = 0.007). We show that 1) cortical GABA-mediated inhibition, as measured by ppTMS, decreases acutely post-TBI, 2) HupA restores lost post-TBI GABA-mediated inhibition, and 3) HupA-mediated enhancement of cortical inhibition is delayed post-TBI. The plausible reasons of the latter include 1) low HupA volume of distribution rendering HupA confined in the intravascular compartment, therefore vulnerable to reduced post-TBI cerebral perfusion, and 2) GABAR dysfunction and increased AChE activity post-TBI.

Acute Ozone (O3) Exposure Accelerates Diet-Induced Pulmonary Injury and Metabolic Alterations in a Rat Model of Type II Diabetes

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Abstract for Society of Toxicology, March 22-25, 2015, San Diego, CAAcute Ozone (O3) Exposure Accelerates Diet-Induced Pulmonary Injury and Metabolic Alterations in a Rat Model of Type II DiabetesS.J. Snow1,3, D. Miller2, V. Bass2, M. Schladweiler3, A. Ledbetter3, J. Richards3, C...

Profile of thoracic injury at College of Medical Sciences Teaching Hospital

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D Chapagain

2014-01-01

Full Text Available Objectives: Thoracic injury is a challenge to the thoracic surgeon practicing in developing countries. This prospective study was conducted to see the mode of injury, injury types and overall outcome of thoracic injury in our settings. Materials and methods: This prospective study was conducted in 100 thoracic injury patients between December 2011 to June 2012. The demographic features, type of the trauma, radiological assessment, associated organ injuries, management of the injury, surgical interventions, morbidity, mortality, length of hospital stay were analysed. Results: In this study the ages ranged from 7 to 84 years. There were 73 (73% males and 27 (27% females. The majority of patients (83% were injured during the evening and night time. The majority of patients 92(92% sustained blunt chest injuries. The mechanism of injury was not significantly associated with length of hospital stay (P > 0.05 and mortality (P > 0.05.Road traffic accident was the most common cause of injuries affecting 68(68% of patients followed by fall injury of 19(19%. Rib fractures, haemothorax, pneumothorax and lung contusion were the most common type of injuries accounting for 83.0%, 57%,34% and 33% respectively. Associated extra-thoracic injuries were noted in 64.0% of patients. 45(45% of the cases of haemothorax, pneumotharax and haemopneumothorax were treated by tube thoracotomy. Four patients (04% had undergone thoracotomy. There were 09(09% patients of flail chest and treated conservatively. Fourty six patients (46% were admitted in the ICU. Eleven (11% patients were treated with ventilator support. Seventeen (17% patients had complication. The overall length of hospital stay ranged from 0 to 25 days. Conclusion: Road traffic accidents and fall from height are the major public health problems. Preventive measures at reducing road traffic accidents and timely management with closed tube thoracotomy are the main factors to be considered in the thoracic

A STUDY ON PATTERN OF INJURIES FOLLOWING RTA

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Jiju George

2016-09-01

Full Text Available BACKGROUND Around three lakh accidents occur in India every year injuring upto 3,40,000 people. Injuries to the pedestrian occur as a result of acceleration process. There can be an abrasion, contusion, laceration or fracture. Injuries can be grouped as  Primary Impact Injuries: This is the first contact of vehicle over the victim’s body. It can be an abrasion or contusion and may bear the design of the part of vehicle which struck the victim. The part of the body involved depends upon the position of the victim or the dimension of the offending vehicle.  Secondary Impact Injuries: Following the primary impact the victim can be scooped up and the vehicle can impact over other parts of his body producing injuries.  Secondary Injuries: These occur when the victim is knocked down following impact. These injuries are as a result of the victim striking the ground or any other intervening object.  Crush Injuries: these are seen when the victim is run over by the vehicle. The severity depends upon the weight of the vehicle. 2 In this study a sincere effort has been put to study the different types of injuries produced in a victim of road traffic accident. This study is intended to help the fellow orthopaedicians to identify quickly and act accordingly and thus prevent the consequences. MATERIALS AND METHODS  The present study was done in the Department of Orthopaedics, Travancore Medical College at Kollam.  The present study was done from March 2015 to march 2016.  A total of 196 cases of RTA were admitted in our hospital during the study period.  Gender distribution, age distribution, type of road user, time of the day when accidents occurred, part of the body injured, types of fracture and injuries sustained that followed was checked.  Detailed clinical history and examination was done and simultaneously noted. INCLUSION CRITERIA Nonfatal injuries was taken up for the study. EXCLUSION CRITERIA Patients who succumbed to

Roentgenologic findings of non-penetrating extracardiac chest injuries

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Kim, Jong Duck; Ra, Woo Youn [Presbyterian Medical Center, Jeonju (Korea, Republic of)

1975-06-15

Of the conventional P-A and A-P chest films which have been studied, many roentgenologic signs suggested for chest trauma. In the present study, an effort was designated to further clarify the x-ray findings of the nonpenetrating extracardiac chest injuries and to observe the x-ray findings being a leading maneuver of surgical procedure. Fat embolism and shock lung must be kept in mind on follow up films. The results thus obtained are summarized as follows; 1. Most of cases are visualized between the age of 10 and 50 and more common in male. 2. The denoting rib fracture, hemopneumothorax, and lung contusion are direct roentgenologic signs. 3. In case of serious result which showed pulmonary edema pattern on conventional chest films, we thought fat embolism or shock lung to be the cause of death.

Competitive Wrestling-related Injuries in School Aged Athletes in U.S. Emergency Departments

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Myers, Richard J

2010-12-01

Full Text Available Objective: To describe the characteristics of wrestling injuries occurring in male athletes aged 7-17 treated in United States (U.S. emergency departments (ED from 2000-2006, and to compare injury patterns between younger & older youth wrestlers.Methods: A stratified probability sample of U.S. hospitals providing emergency services in the National Electronic Injury Surveillance System was used for 2000-2006. ED visits for injuries sustained in organized wrestling were analyzed for male patients ages 7-17 years old (subdivided into 7-11 years old [youth group] and 12-17 years old [scholastic group].Results: During the study period, there were an estimated 167,606 ED visits for wrestling injuries in 7-17 years old U.S. males, with 152,710 (91.1% occurring in the older (12-17 years old group. The annual injury incidence was 6.49 injuries/1,000 wrestlers in the youth group and 29.57 injuries/1,000 wrestlers in the scholastic group. The distribution of diagnoses was similar in both age groups, with sprain/strain as the most common diagnosis, followed by fracture and contusion/abrasion. Distributions of injury by location were significantly different between groups (p=0.02, although both groups exhibited approximately 75% of all injuries from the waist up. Overexertion and struck by/against were the most common precipitating and direct mechanisms in both groups, respectively. Over 97% of all injured wrestlers were treated and released.Conclusion: The types of injury in youth (7-11 years old wrestlers are similar to those of scholastic (12-17 years old wrestlers, although the distribution of body parts injured differs between the age groups. The majority of injuries occurs above the waist and may be a target for prevention strategies. [West J Emerg Med. 2010; 11(5:442-449.

MR imaging of the central nervous system in victims of child abuse

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Zimmerman, R.A.; Ludwig, S.; Bilaniuk, L.T.; Rafto, E.; Hackney, D.B.; Goldberg, H.I.; Grossman, R.I.

1986-01-01

Six victims of child abuse with intracranial injury were examined by high-field MR (1.5-T). In comparison with CT, MR proved to be much more sensitive and accurate in the demonstration and anatomic localization of subacute and chronic hematomas and hemorrhagic contusions. Ischemic white matter changes in the young infant were more easily appreciated on serial CT examinations than on MR studies because of the variable signal intensity found in the myelinating white matter. Contusions represent a large component of the injuries seen in the whiplash infant. Because of its rapidity, CT remains the initial procedure for overall evaluation of injury and for exclusion of operable hematomas

Splenic abscess after splenic blunt injury angioembolization.

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Tartaglia, Dario; Galatioto, Christian; Lippolis, Piero Vincenzo; Modesti, Matteo; Gianardi, Desirée; Bertolucci, Andrea; Cucinotta, Monica; Zocco, Giuseppe; Seccia, Massimo

2014-11-03

Splenic Angioembolization (SAE), during Nonoperative Management (NOM) of Blunt Splenic Injury (BSI), is an effective therapy for hemodynamically stable patients with grade III, IV, and V OIS splenic injuries. We report a case of a patient with a blunt abdominal trauma due to an accidental fall, who presented splenic abscess a week after SAE and a review of the literature. A 38-year-old male arrived at Emergency after an accidental fall with contusion of the left upper quadrant of the abdomen. Abdominal CT scan revealed the fracture of the lower splenic pole with intraparenchymal pseudoaneurysms (OIS spleen injury scale IV). Considering the hemodynamic stability, NOM was undertaken and SAE was performed. After a week, the patient developed a splenic abscess confirmed by Abdominal CT; therefore, splenectomy was performed. There was no evidence of bacterial growing in the perisplenic hematoma cultures but the histological examination showed multiple abscess and hemorrhagic areas in the spleen. Splenic abscess after SAE during NOM of BSI is a rare major complication. The most frequently cultured organisms include Clostridium perfringens, Alpha-Hemoliticus Streptococcus, gram-positive Staphylococcus, gram-negative Salmonella, Candida, and Aspergillus. This case represents our first reported splenic abscess after SAE. SAE is a very useful tool for BSI managing; splenic abscess can occur in a short time, even if it is a rare major complication, so it may be useful to monitor patients undergoing SAE, focusing not only on the hemodynamic parameters but also on the inflammatory and infectious aspects.

A COMPARISON OF WAKEBOARD-, WATER SKIING-, AND TUBING-RELATED INJURIES IN THE UNITED STATES, 2000-2007

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John I. Baker

2010-03-01

Full Text Available The purpose of the study was to compare tubing-related injuries to wakeboarding- and water skiing-related injuries. Data was collected from the 2000-2007 National Electronic Injury Surveillance Survey for 1,761 individuals seeking care at an emergency department due to a tubing-, wakeboarding, or water skiing-related injury. Data included patient age and sex, as well as injury characteristics including body region injured (i.e., head and neck, trunk, shoulder and upper extremity, and hip and lower extremity and diagnosis of injury (e.g., contusion, laceration, or fracture. Case narratives were reviewed to ensure that a tubing-, wakeboarding-, or water skiing-related injury occurred while the individual was being towed behind a boat. Severe injury (defined as an injury resulting in the individual being hospitalized, transferred, held for observation was compared among the groups using logistic regression. Wakeboard- and tubing-related injuries more commonly involved the head and neck, while water skiing- related injuries were likely to involve the hip and lower extremity. Tubing-related injuries, compared to water skiing-related injuries, were more likely to be severe (OR 2.31, 95% CI 1.23-4. 33. Like wakeboarding and water skiing, tubing has inherent risks that must be understood by the participant. While tubing is generally considered a safer alternative to wakeboarding and water skiing, the results of the current study suggest otherwise. Both the number and severity of tubing- related injuries could be prevented through means such as advocating the use of protective wear such as helmets while riding a tube or having recommended safe towing speeds prominently placed on inner tubes

Atypical stab injury suggesting ritual suicide

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Štěpánka Kučerová

2016-11-01

Full Text Available Sharp weapons have been one of the most common deadly tools in cases of homicide and suicide for a long time. Tentative incisions accompany the majority of suicides by sharp force and the absence of hesitation marks provokes questions about the manner of death. We present the bizarre fatality of a 41-year-old male with an isolated circumscribed incision on the right neck, where the body was found lying in a pool of blood in the shower of his apartment. The internal examination revealed a 4-cm-long channel-like defect running inwardly and downwardly along the right sternocleidomastoid region. The cause of death was external bleeding from an injured right carotid artery and internal jugular vein. The wound had clean non-contused margins without any conspicuous hesitation injuries. A fragment of a razor blade, found in blood splatters, was identified as the only potential injuring tool. The case was classified as a suicide.

Injuries associated with the use of riding mowers in the United States, 2002-2007.

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Hammig, Bart; Childers, Elizabeth; Jones, Ches

2009-10-01

To examine injuries among patients treated in an emergency department (ED) related to the use of a riding lawn mower. Data were obtained from the National Electronic Injury Surveillance System for the years 2002-2007. National estimates of ED visits for injuries associated with the use of a riding lawn mower were analyzed. Narrative text entries were categorized to provide a detailed record of the circumstances precipitating the injury. Average annual rates were calculated and logistic regression analyses were employed to determine risk estimates for patient disposition and demographic characteristics related to ED visits for injuries associated with riding mowers. From 2002 through 2007, there were an estimated 66,341 ED visits for injuries related to the use of riding lawnmowers in the U.S., with an average annual rate of 6.0 ED visits per 100,000 males, and 1.6 ED visits per 100,000 females. Older adults had higher rates of ED visits for injuries (7.2/100,000) than younger age groups. The most common injuries involved contusions (24%); sprains/strains (22%) and fractures (17%). The majority of patients (90%) were treated and released the same day. Results of logistic regression analyses revealed that older adults were more likely to be hospitalized when compared to younger age groups; and incidents involving rollovers [OR=5.45 (95% CI=3.22-9.23)] and being run over [6.01 (95% CI 3.23-11.17)] were more likely to result in hospitalization when compared to all other circumstances of injury. Riding mowers present injury patterns and circumstances that are different than those reported for push mowers. Circumstances related to injuries and age groups affected were varied, making prevention of riding mower injuries challenging. APPLICATION/IMPACT: Findings support the need to increase awareness and/or change the design of riding mowers with respect to risk of rollover injuries.

Sports injuries: population based representative data on incidence, diagnosis, sequelae, and high risk groups.

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Schneider, S; Seither, B; Tönges, S; Schmitt, H

2006-04-01

To generate national representative data on the incidence, diagnosis, severity, and nature of medically treated sports injuries and to identify high risk groups. The first national health survey for the Federal Republic of Germany, conducted in the format of a standardised, written, cross sectional survey in the period October 1997 to March 1999, gathered data on the incidence of accident and injury and information on social demographics, injury related disability/time off work, and injury location/setting. The net sample comprised 7124 people aged 18-79. 3.1% of adult Germans said they sustained a sports injury during the previous year, corresponding to an annual injury rate of 5.6% among those engaging in regular recreational physical activity and ranking sports injuries as the second most common type of accident. About 62% of all sports injuries result in time taken off work. The period of occupational disability is 14 days or less in around two thirds of these cases. The occupational disability rate after occupational and traffic accidents is much higher by comparison. Dislocations, distortions, and/or torn ligaments make up 60% of all sports injuries, followed by fractures (18%), contusions, surface wounds, or open wounds (12%). Three out of four sports injury casualties are male. The incidence declines noticeably in higher age groups. Future injury prevention measures should focus on the high risk group of young male recreational athletes. The data indicate that the fear of damage to health and injury, believed to be significant internal psychological barriers to participation in sports, is largely unwarranted for the female population and/or older age groups. Sporting injuries are a marginal phenomenon among the female population and mobile seniors actively engaged in sports.

Development of a 3D matrix for modeling mammalian spinal cord injury in vitro

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Juan Felipe Diaz Quiroz

2016-01-01

Full Text Available Spinal cord injury affects millions of people around the world, however, limited therapies are available to improve the quality of life of these patients. Spinal cord injury is usually modeled in rats and mice using contusion or complete transection models and this has led to a deeper understanding of the molecular and cellular complexities of the injury. However, it has not to date led to development of successful novel therapies, this is in part due to the complexity of the injury and the difficulty of deciphering the exact roles and interactions of different cells within this complex environment. Here we developed a collagen matrix that can be molded into the 3D tubular shape with a lumen and can hence support cell interactions in a similar architecture to a spinal cord. We show that astrocytes can be successfully grown on this matrix in vitro and when injured, the cells respond as they do in vivo and undergo reactive gliosis, one of the steps that lead to formation of a glial scar, the main barrier to spinal cord regeneration. In the future, this system can be used to quickly assess the effect of drugs on glial scar protein activity or to perform live imaging of labeled cells after exposure to drugs.

Therapeutic effects of NogoA vaccine and olfactory ensheathing glial cell implantation on acute spinal cord injury

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Zhang Z

2013-10-01

Full Text Available Zhicheng Zhang, Fang Li, Tiansheng Sun, Dajiang Ren, Xiumei Liu PLA Institute of Orthopedics, Beijing Army General Hospital, Beijing, People's Republic of China Background: Many previous studies have focused on the effects of IN-1, a monoclonal antibody that neutralizes Nogo (a neurite growth inhibitory protein, on neurologic regeneration in spinal cord injury (SCI. However, safety problems and the short half-life of the exogenous antibody are still problematic. In the present study, the NogoA polypeptide was used as an antigen to make a therapeutic NogoA vaccine. Rats were immunized with this vaccine and were able to secrete the polyclonal antibody before SCI. The antibody can block NogoA within the injured spinal cord when the antibody gains access to the spinal cord due to a compromised blood–spinal cord barrier. Olfactory ensheathing glial cell transplantation has been used in a spinal cord contusion model to promote the recovery of SCI. The present study was designed to verify the efficacy and safety of NogoA polypeptide vaccine, the effects of immunotherapy with this vaccine, and the synergistic effects of the vaccine and olfactory ensheathing glial cells in repair of SCI. Methods: A 13-polypeptide fragment of NogoA was synthesized. This fragment was then coupled with keyhole limpet hemocyanin to improve the immunogenicity of the polypeptide vaccine. Immunization via injection into the abdominal cavity was performed in rats before SCI. The serum antibody level and ability of the vaccine to bind with Nogo were detected by enzyme-linked immunosorbent assay. The safety of the vaccine was evaluated according to the incidence and severity of experimental autoimmune encephalomyelitis. Olfactory ensheathing glia cells were obtained, purified, and subsequently implanted into a Wistar rat model of thoracic spinal cord contusion injury. The rats were divided into four groups, ie, an SCI model group, an olfactory ensheathing glia group, a vaccine

Evaluating the injury incidence from skate shoes in the United States.

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Ruth, Erin; Shah, Binisa; Fales, Willliam

2009-05-01

The goals of this study were to evaluate whether the increased use of skate shoes may lead to an increase in injuries for children and adolescents aged 5 to 14 years in the United States and to describe the types of injuries reported by emergency departments as a result of skate shoe use. Retrospective analysis of the National Electronic Injury Surveillance System database from January 1, 2002 to December 31, 2006 for injuries resulting from footwear in children and adolescents aged 5 to 14 years. Injuries resulting from skate shoe use were identified by manual review of the data. For the 5-year period, an estimated 3525 patients between 5 and 14 years of age were treated in United States emergency departments for injuries resulting from skate shoe use. The percentage of injuries resulting from skate shoes of total footwear-related injuries varied by year, however, with 1.0%, 1.0%, 0.8%, and 1.9% occurring in 2002 to 2005, respectively, and 11.8% occurring in 2006. This substantial increase in 2006 accounts for 73.6% of skate shoe-related injuries and is statistically significant (chi, P = skate shoe sales, with a correlation coefficient of 0.9982.Most of the injured children and adolescents were white, and there was a slight, nonsignificant predominance of boys. Most injuries in all 5-year-olds were fractures (46.7%), followed by contusions (17.9%) and sprains (17.2%). The most frequent site of fracture was the forearm (38.4%), followed by the wrist (35.1%) and the leg (14.9%). Other injuries included lacerations (7.3%), concussions (6.6%), internal organ injuries (0.9%), hematomas (0.2%), dislocations (0.2%), and injuries not otherwise specified (3.1%). Based on national estimates, 104 (0.01%) patients required admission to the hospital. No injuries recorded in the National Electronic Injury Surveillance System database resulted in death. As the first study analyzing injury rates as a result of skate shoe use in the United States, this study demonstrated a recent

Recovered neuronal viability revealed by Iodine-123-iomazenil SPECT following traumatic brain injury.

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Koizumi, Hiroyasu; Fujisawa, Hirosuke; Kurokawa, Tetsu; Suehiro, Eiichi; Iwanaga, Hideyuki; Nakagawara, Jyoji; Suzuki, Michiyasu

2010-10-01

We evaluated cortical damages following traumatic brain injury (TBI) in the acute phase with [(123)I] iomazenil (IMZ) single photon emission computed tomography (SPECT). In all, 12 patients with cerebral contusion following TBI were recruited. All patients underwent IMZ SPECT within 1 week after TBI. To investigate the changes in distribution of IMZ in the cortex in the chronic phase, after conventional treatment, patients underwent IMZ SPECT again. A decrease in the accumulation of radioligand for the central benzodiazepine receptor in the cortex corresponding to the contusion revealed with computed tomography (CT) scans and magnetic resonance imaging (MRI) were shown on IMZ SPECT in the acute phase in all patients. In 9 of 12 patients (75%), images of IMZ SPECT obtained in the chronic phase of TBI showed that areas with a decreased distribution of IMZ were remarkably reduced in comparison with those obtained in the acute phase. Both CT scans and MRI showed a normal appearance of the cortex morphologically, where the binding potential of IMZ recovered in the chronic phase. Reduced binding potential of radioligand for the central benzodiazepine receptor is considered to be an irreversible reaction; however, in this study, IMZ accumulation in the cortex following TBI was recovered in the chronic phase in several patients. [(123)I] iomazenil SPECT may have a potential to disclose a reversible vulnerability of neurons following TBI.

Unintentional fall injuries associated with walkers and canes in older adults treated in U.S. emergency departments.

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Stevens, Judy A; Thomas, Karen; Teh, Leesia; Greenspan, Arlene I

2009-08-01

To characterize nonfatal, unintentional, fall-related injuries associated with walkers and canes in older adults. Surveillance data of injuries treated in hospital emergency departments (EDs), January 1, 2001, to December 31, 2006. The National Electronic Injury Surveillance System All Injury Program, which collects data from a nationally representative stratified probability sample of 66 U.S. hospital EDs. People aged 65 and older treated in EDs for 3,932 nonfatal unintentional fall injuries and whose records indicated that a cane or a walker was involved in the fall. Sex, age, whether the fall involved a cane or walker, primary diagnosis, part of the body injured, disposition, and location and circumstances of the fall. An estimated 47,312 older adult fall injuries associated with walking aids were treated annually in U.S. EDs: 87.3% with walkers, 12.3% with canes, and 0.4% with both. Walkers were associated with seven times as many injuries as canes. Women's injury rates exceeded those for men (rate ratios=2.6 for walkers, 1.4 for canes.) The most prevalent injuries were fractures and contusions or abrasions. Approximately one-third of subjects were hospitalized for their injuries. Injuries and hospital admissions for falls associated with walking aids were frequent in this highly vulnerable population. The results suggest that more research is needed to improve the design of walking aids. More information also is needed about the circumstances preceding falls, both to better understand the contributing fall risk factors and to develop specific and effective fall prevention strategies.

Gamma-Secretase Inhibitors Attenuate Neurotrauma and Neurogenic Acute Lung Injury in Rats by Rescuing the Accumulation of Hypertrophic Microglia

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Hung-Jung Lin

2017-12-01

Full Text Available Background/Aims: In response to traumatic brain injury (TBI, activated microglia exhibit changes in their morphology from the resting ramified phenotype toward the activated hypertrophic or amoeboid phenotype. Here, we provide the first description of the mechanism underlying the neuroprotective effects of γ-secretase inhibitors on TBI outcomes in rats. Methods: The neuroprotective effects of γ-secretase inhibitors such as LY411575 or CHF5074 on TBI-induced neurotoxicity were analysed using a neurological motor function evaluation, cerebral contusion assay, immunohistochemical staining for microglia phenotypes, lung injury score and Evans Blue dye extravasation assay of brain and lung oedema. Results: Hypertrophic or amoeboid microglia accumulated in the injured cortex, the blood-brain-barrier was disrupted and neurological deficits and acute lung injury were observed 4 days after TBI in adult rats. However, a subcutaneous injection of LY411575 (5 mg/kg or CHF5074 (30 mg/kg immediately after TBI and once daily for 3 consecutive days post-TBI significantly attenutaed the accumulation of hypertrophic microglia in the injured brain, neurological injury, and neurogenic acute lung injury. Conclusion: Gamma-secretase inhibitors attenuated neurotrauma and neurogenic acute lung injury in rats by reducing the accumulation of hypertrophic microglia in the vicinity of the lesion.

The endogenous proteoglycan-degrading enzyme ADAMTS-4 promotes functional recovery after spinal cord injury

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Tauchi Ryoji

2012-03-01

Full Text Available Abstract Background Chondroitin sulfate proteoglycans are major inhibitory molecules for neural plasticity under both physiological and pathological conditions. The chondroitin sulfate degrading enzyme chondroitinase ABC promotes functional recovery after spinal cord injury, and restores experience-dependent plasticity, such as ocular dominance plasticity and fear erasure plasticity, in adult rodents. These data suggest that the sugar chain in a proteoglycan moiety is essential for the inhibitory activity of proteoglycans. However, the significance of the core protein has not been studied extensively. Furthermore, considering that chondroitinase ABC is derived from bacteria, a mammalian endogenous enzyme which can inactivate the proteoglycans' activity is desirable for clinical use. Methods The degradation activity of ADAMTS-4 was estimated for the core proteins of chondroitin sulfate proteoglycans, that is, brevican, neurocan and phosphacan. To evaluate the biological significance of ADMATS-4 activity, an in vitro neurite growth assay and an in vivo neuronal injury model, spinal cord contusion injury, were employed. Results ADAMTS-4 digested proteoglycans, and reversed their inhibition of neurite outgrowth. Local administration of ADAMTS-4 significantly promoted motor function recovery after spinal cord injury. Supporting these findings, the ADAMTS-4-treated spinal cord exhibited enhanced axonal regeneration/sprouting after spinal cord injury. Conclusions Our data suggest that the core protein in a proteoglycan moiety is also important for the inhibition of neural plasticity, and provides a potentially safer tool for the treatment of neuronal injuries.

Orofacial injuries reported by professional and non-professional basketball players in zagreb and zagreb county.

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Seifert, Davor; Lešić, Nikolina; Šostar, Zvonimir

2014-12-01

Injuries are common during sport activities, a part of which is also injuries to the stomatognathic system. According to the data from literature orofacial injuries are frequent, but relatively minor. World Dental Federation has listed basketball as a medium-risk sport in sustaining orofacial injuries. The purpose of this investigation was to determine incidence, type and severity of orofacial injuries during basketball and frequents of mouthguard use. The sample consisted of 195 athletes who actively participate in basketball, 60 amateurs/non-professional and 135 professionals. A total of 2 265 injuries to the stomatognathic system were documented in this research; 200 (8.8%) of those injuries refer to the non-professionals and 2 065 (91.2%) to the professionals. The most common injuries are lacerations and contusions of soft tissue (a total of 2 208 or 97.5%), followed by dental injuries (a total of 57 or 2.5%). Out of all recorded laceration injuries 59.8% lacerations of soft tissue occurred during practice (12.6% amateurs and 87.4% professionals), while 40.2% of them occurred during games (2.5% amateurs and 97.5% professionals). Of a total of 57 dental injuries recorded during an athletes career, in 78.9% it were the professionals who suffered an injury, and in 21.1% of them the amateurs. Out of a total of 195 basketball players only 1% (2 players - one professional and one amateur) frequently used mouthguard during practice and games, while 93.3% of them never tried to wear a mouthguard. Such low percentage of mouthguard use in basketball players reflects poor awareness and education of athletes and coaches, as well as insufficient role of dentists in education. Orofacial injuries during basketball are not severe (80% lacerations), and therefore do not stimulate the use of a protecting devices even their use will totally diminish this type of injuries.

Efficacy and safety assessment of acute sports-related traumatic soft tissue injuries using a new ibuprofen medicated plaster: results from a randomized controlled clinical trial.

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Predel, Hans-Georg; Connolly, Mark P; Bhatt, Aomesh; Giannetti, Bruno

2017-11-01

To investigate the efficacy and safety of a recently developed ibuprofen medicated plaster in the treatment of acute sports impact injuries/contusions. In this double-blind, multi-center, placebo-controlled, parallel group, phase 3 study (EudraCT Number: 2012-003257-2) patients (n = 132; ages 18 to 60 years) diagnosed with acute sports-related traumatic blunt soft tissue injury/contusion to the upper or lower limbs were randomized to receive either ibuprofen 200 mg plaster (n = 64) or placebo plaster (n = 68). Plasters were administered once daily for five consecutive days. The primary assessment was the area under the curve (AUC) of the visual analogue scale (VAS) of pain on movement (POM) over 0 to 72 h (VAS 0-72 ). The ibuprofen medicated plaster was associated with a reduction in pain on movement (POM) based on lower VAS AUC 0-72h (2399.4 mm*h) compared with placebo (4078.9 mm*h) (least squares mean difference: - 1679.5 mm*h; P ibuprofen medicated plaster compared with placebo at 12, 48, 24, and 120 h (P ibuprofen medicated plaster was associated with greater reduction in tenderness/pain than placebo at each timepoint (P values ibuprofen plaster, and n = 6 [8.8%] for placebo). All drug-related AEs were administration site reactions and were mild in intensity. The results of this study indicate that ibuprofen medicated plaster results in rapid and clinically relevant reduction of pain in patients suffering from blunt musculoskeletal injuries or recurrent pain. The ibuprofen medicated plaster was well tolerated.

Neuromuscular stimulation therapy after incomplete spinal cord injury promotes recovery of interlimb coordination during locomotion

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Jung, R.; Belanger, A.; Kanchiku, T.; Fairchild, M.; Abbas, J. J.

2009-10-01

The mechanisms underlying the effects of neuromuscular electrical stimulation (NMES) induced repetitive limb movement therapy after incomplete spinal cord injury (iSCI) are unknown. This study establishes the capability of using therapeutic NMES in rodents with iSCI and evaluates its ability to promote recovery of interlimb control during locomotion. Ten adult female Long Evans rats received thoracic spinal contusion injuries (T9; 156 ± 9.52 Kdyne). 7 days post-recovery, 6/10 animals received NMES therapy for 15 min/day for 5 days, via electrodes implanted bilaterally into hip flexors and extensors. Six intact animals served as controls. Motor function was evaluated using the BBB locomotor scale for the first 6 days and on 14th day post-injury. 3D kinematic analysis of treadmill walking was performed on day 14 post-injury. Rodents receiving NMES therapy exhibited improved interlimb coordination in control of the hip joint, which was the specific NMES target. Symmetry indices improved significantly in the therapy group. Additionally, injured rodents receiving therapy more consistently displayed a high percentage of 1:1 coordinated steps, and more consistently achieved proper hindlimb touchdown timing. These results suggest that NMES techniques could provide an effective therapeutic tool for neuromotor treatment following iSCI.

Immunization with a Neural-Derived Peptide Protects the Spinal Cord from Apoptosis after Traumatic Injury

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Roxana Rodríguez-Barrera

2013-01-01

Full Text Available Apoptosis is one of the most destructive mechanisms that develop after spinal cord (SC injury. Immunization with neural-derived peptides (INDPs such as A91 has shown to reduce the deleterious proinflammatory response and the amount of harmful compounds produced after SC injury. With the notion that the aforementioned elements are apoptotic inducers, we hypothesized that INDPs would reduce apoptosis after SC injury. In order to test this assumption, adult rats were subjected to SC contusion and immunized either with A91 or phosphate buffered saline (PBS; control group. Seven days after injury, animals were euthanized to evaluate the number of apoptotic cells at the injury site. Apoptosis was evaluated using DAPI and TUNEL techniques; caspase-3 activity was also evaluated. To further elucidate the mechanisms through which A91 exerts this antiapoptotic effects we quantified tumor necrosis factor-alpha (TNF-α. To also demonstrate that the decrease in apoptotic cells correlated with a functional improvement, locomotor recovery was evaluated. Immunization with A91 significantly reduced the number of apoptotic cells and decreased caspase-3 activity and TNF-α concentration. Immunization with A91 also improved the functional recovery of injured rats. The present study shows the beneficial effect of INDPs on preventing apoptosis and provides more evidence on the neuroprotective mechanisms exerted by this strategy.

Heading and head injuries in soccer.

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Kirkendall, D T; Jordan, S E; Garrett, W E

2001-01-01

In the world of sports, soccer is unique because of the purposeful use of the unprotected head for controlling and advancing the ball. This skill obviously places the player at risk of head injury and the game does carry some risk. Head injury can be a result of contact of the head with another head (or other body parts), ground, goal post, other unknown objects or even the ball. Such impacts can lead to contusions, fractures, eye injuries, concussions or even, in rare cases, death. Coaches, players, parents and physicians are rightly concerned about the risk of head injury in soccer. Current research shows that selected soccer players have some degree of cognitive dysfunction. It is important to determine the reasons behind such deficits. Purposeful heading has been blamed, but a closer look at the studies that focus on heading has revealed methodological concerns that question the validity of blaming purposeful heading of the ball. The player's history and age (did they play when the ball was leather and could absorb significant amounts of water), alcohol intake, drug intake, learning disabilities, concussion definition and control group use/composition are all factors that cloud the ability to blame purposeful heading. What does seem clear is that a player's history of concussive episodes is a more likely explanation for cognitive deficits. While it is likely that the subconcussive impact of purposeful heading is a doubtful factor in the noted deficits, it is unknown whether multiple subconcussive impacts might have some lingering effects. In addition, it is unknown whether the noted deficits have any affect on daily life. Proper instruction in the technique is critical because if the ball contacts an unprepared head (as in accidental head-ball contacts), the potential for serious injury is possible. To further our understanding of the relationship of heading, head injury and cognitive deficits, we need to: learn more about the actual impact of a ball on the

[Clinical epidemiological assessments on 3521 patients suffering from road traffic injuries, in relation with trauma localisation and severity, assisted in "Sf. Ioan" Emergency Unit, during 2002-2009].

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Manole, M; Ciuhodaru, T; Zanoschi, Georgeta; Manole, Alina; Ivan, A

2011-01-01

The aim of study was to assess road traffic injuries in relation with their localisation and severity. A sample of 3521 patients suffering from road traffic injuries and assisted in "Sf. Ioan" Emergency Unit, Iaşi, Romania was assess regarding age group, sex and residence area, type of lesions and ther localisation and severity, between 2002-2009. Data were collected using a special epidemiological inquiry and processed using SPSS and MS Excel statistical softs. The incidence of road traffic injuries increased during the last decade, with a report men/women of 1.5, urban and 21-30 age group predominance. The most frequent were leg fractures (16.7%) and thoracal contusions (19.1%), cranial and facial trauma (32.4%), with open injuries (10.5%). Prevention programmes with a high efficiency at the national level, as well as a concret identification of risk factors with a multidisciplinar approach of road traffic accidents, are needed.

How children with head injury represent real and deceptive emotion in short narratives.

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Dennis, M; Barnes, M A; Wilkinson, M; Humphreys, R P

1998-02-15

Narratives are not only about events, but also about the emotions those events elicit. Understanding a narrative involves not just the affective valence of implied emotional states, but the formation of an explicit mental representation of those states. In turn, this representation provides a mechanism that particularizes emotion and modulates its display, which then allows emotional expression to be modified according to particular contexts. This includes understanding that a character may feel an emotion but inhibit its display or even express a deceptive emotion. We studied how 59 school-aged children with head injury and 87 normally-developing age-matched controls understand real and deceptive emotions in brief narratives. Children with head injury showed less sensitivity than controls to how emotions are expressed in narratives. While they understood the real emotions in the text, and could recall what provoked the emotion and the reason for concealing it, they were less able than controls to identify deceptive emotions. Within the head injury group, factors such as an earlier age at head injury and frontal lobe contusions were associated with poor understanding of deceptive emotions. The results are discussed in terms of the distinction between emotions as felt and emotions as a cognitive framework for understanding other people's actions and mental states. We conclude that children with head injury understand emotional communication, the spontaneous externalization of real affect, but not emotive communication, the conscious, strategic modification of affective signals to influence others through deceptive facial expressions.

Role of computed tomography in blunt chest trauma

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Cho, Jae Hyun; Kim, Sang Jin; Lee, Chan Wha; Kim, Hae Kyoon

1994-01-01

In patient with blunt trauma of chest, supine AP x-ray cannot differentiate the lung contusion, laceration, atelectasis, and hemothorax definitely. Therefore, computed tomographic evaluation is needed for accurate evaluation of the injuries. In our knowledge, there are few reports about CT findings of blunt chest trauma, in our country, therefore we tried to fluid the characteristic CT findings in patients with blunt trauma. We analyzed the plain x-ray and CT image of 4 patients with blunt chest trauma. Location and morphology of lung parenchymal contusion and laceration, hemopneumothorax, chest wall injuries and location of chest tube. Lung parenchymal contusion was noted in 53 segments., of 16 patients infiltration(n=27 segment), and multiple nodular pattern was noted in 15 segment, pattern of consolidation along the lung periphery was seen in 11 segment. Laceration was noted in 18 lesion and most commonly located in paravertebral area(b=8). CT scan of chest in patient with blunt chest trauma, provides accurate information of the pattern of injuries, and localization, therefore, should be performed as possible

Synaptic reorganization of inhibitory hilar interneuron circuitry after traumatic brain injury in mice

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Hunt, Robert F.; Scheff, Stephen W.; Smith, Bret N.

2011-01-01

Functional plasticity of synaptic networks in the dentate gyrus has been implicated in the development of posttraumatic epilepsy and in cognitive dysfunction after traumatic brain injury, but little is known about potentially pathogenic changes in inhibitory circuits. We examined synaptic inhibition of dentate granule cells and excitability of surviving GABAergic hilar interneurons 8–13 weeks after cortical contusion brain injury in transgenic mice that express enhanced green fluorescent protein in a subpopulation of inhibitory neurons. Whole-cell voltage-clamp recordings in granule cells revealed a reduction in spontaneous and miniature IPSC frequency after head injury; no concurrent change in paired-pulse ratio was found in granule cells after paired electrical stimulation of the hilus. Despite reduced inhibitory input to granule cells, action potential and EPSC frequencies were increased in hilar GABA neurons from slices ipsilateral to the injury, versus those from control or contralateral slices. Further, increased excitatory synaptic activity was detected in hilar GABA neurons ipsilateral to the injury after glutamate photostimulation of either the granule cell or CA3 pyramidal cell layers. Together, these findings suggest that excitatory drive to surviving hilar GABA neurons is enhanced by convergent input from both pyramidal and granule cells, but synaptic inhibition of granule cells is not fully restored after injury. This rewiring of circuitry regulating hilar inhibitory neurons may reflect an important compensatory mechanism, but it may also contribute to network destabilization by increasing the relative impact of surviving individual interneurons in controlling granule cell excitability in the posttraumatic dentate gyrus. PMID:21543618

A case of lethal soft tissue injuries due to assault

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Yanagawa Y

2012-05-01

Full Text Available Youichi Yanagawa,1 Yoshimasa Kanawaku,2 Jun Kanetake21Department of Emergency and Disaster Medicine, Juntendo University, Tokyo, 2Department of Forensic Medicine, National Defense Medical College, Saitama, JapanAbstract: A 42-year-old male had been assaulted by his family over the two previous days and went into a deep coma. When the emergency technician arrived, the patient was in a state of cardiopulmonary arrest. On arrival, his electrocardiogram showed asystole. His body showed swelling with subcutaneous hemorrhage, suggesting multiple contusional wounds. Serum biochemistry evaluation revealed blood urea nitrogen of 80 mg/dL, creatinine of 5.99 mg/dL, creatine phosphokinase of 10,094 IU/L, and potassium of 11.0 mEq/L. Advanced cardiopulmonary resuscitation failed to obtain a return of spontaneous circulation. Laboratory findings revealed rhabdomyolysis, renal failure, and hyperkalemia. Autopsy did not indicate the direct cause of death to be traumatic organ injuries. Because trauma was not the direct reason of death, we speculated that the patient died of hyperkalemia induced by multiple contusional soft tissue injuries, following rhabdomyolysis, hemolysis, and acute renal failure. The physician should maintain a high index of suspicion for hyperkalemia induced by rhabdomyolysis and acute renal failure, especially in patients presenting with symptoms of multiple soft tissue injuries with massive subcutaneous hemorrhaging.Keywords: contusion, rhabdomyolysis, renal failure, hyperkalemia

Digital radiography of crush thoracic trauma in the Sichuan earthquake

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Dong, Zhi-Hui; Shao, Heng; Chen, Tian-Wu; Chu, Zhi-Gang; Deng, Wen; Tang, Si-Shi; Chen, Jing; Yang, Zhi-Gang

2011-01-01

AIM: To investigate the features of crush thoracic trauma in Sichuan earthquake victims using chest digital radiography (CDR). METHODS: We retrospectively reviewed 772 CDR of 417 females and 355 males who had suffered crush thoracic trauma in the Sichuan earthquake. Patient age ranged from 0.5 to 103 years. CDR was performed between May 12, 2008 and June 7, 2008. We looked for injury to the thoracic cage, pulmonary parenchyma and the pleura. RESULTS: Antero-posterior (AP) and lateral CDR were obtained in 349 patients, the remaining 423 patients underwent only AP CDR. Thoracic cage fractures, pulmonary contusion and pleural injuries were noted in 331 (42.9%; 95% CI: 39.4%-46.4%), 67 and 135 patients, respectively. Of the 256 patients with rib fractures, the mean number of fractured ribs per patient was 3. Rib fractures were mostly distributed from the 3rd through to the 8th ribs and the vast majority involved posterior and lateral locations along the rib. Rib fractures had a significant positive association with non-rib thoracic fractures, pulmonary contusion and pleural injuries (P < 0.001). The number of rib fractures and pulmonary contusions were significant factors associated with patient death. CONCLUSION: Earthquake-related crush thoracic trauma has the potential for multiple fractures. The high number of fractured ribs and pulmonary contusions were significant factors which needed appropriate medical treatment. PMID:22132298

Altering CO2 during reperfusion of ischemic cardiomyocytes modifies mitochondrial oxidant injury.

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Lavani, Romeen; Chang, Wei-Tien; Anderson, Travis; Shao, Zuo-Hui; Wojcik, Kimberly R; Li, Chang-Qing; Pietrowski, Robert; Beiser, David G; Idris, Ahamed H; Hamann, Kimm J; Becker, Lance B; Vanden Hoek, Terry L

2007-07-01

species. Altering CO2 content during reperfusion can significantly affect myocardial postresuscitation injury, in part by modifying mitochondrial oxidants and NO synthase-induced NO production.

Proteomics analysis after traumatic brain injury in rats: the search for potential biomarkers

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Jun Ding

2015-04-01

Full Text Available Many studies of protein expression after traumatic brain injury (TBI have identified biomarkers for diagnosing or determining the prognosis of TBI. In this study, we searched for additional protein markers of TBI using a fluid perfusion impact device to model TBI in S-D rats. Two-dimensional gel electrophoresis and mass spectrometry were used to identify differentially expressed proteins. After proteomic analysis, we detected 405 and 371 protein spots within a pH range of 3-10 from sham-treated and contused brain cortex, respectively. Eighty protein spots were differentially expressed in the two groups and 20 of these proteins were identified. This study validated the established biomarkers of TBI and identified potential biomarkers that could be examined in future work.

Agmatine Modulates the Phenotype of Macrophage Acute Phase after Spinal Cord Injury in Rats.

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Kim, Jae Hwan; Kim, Jae Young; Mun, Chin Hee; Suh, Minah; Lee, Jong Eun

2017-10-01

Agmatine is a decarboxylated arginine by arginine decarboxylase. Agmatine is known to be a neuroprotective agent. It has been reported that agmatine works as a NMDA receptor blocker or a competitive nitric oxide synthase inhibitor in CNS injuries. In spinal cord injury, agmatine showed reduction of neuropathic pain, improvement of locomotor function, and neuroprotection. Macrophage is a key cellular component in neuroinflammation, a major cause of impairment after spinal cord injury. Macrophage has subtypes, M1 and M2 macrophages. M1 macrophage induces a pro-inflammatory response, but M2 inspires an anti-inflammatory response. In this study, it was clarified whether the neuroprotective effect of agmatine is related with the modulation of macrophage subdivision after spinal cord injury. Spinal cord injury was induced in rats with contusion using MASCIS. Animals received agmatine (100 mg/kg, IP) daily for 6 days beginning the day after spinal cord injury. The proportion of M1 and M2 macrophages are confirmed with immunohistochemistry and FACS. CD206 + & ED1 + cells were counted as M2 macrophages. The systemic treatment of agmatine increased M2 macrophages caudal side to epicenter 1 week after spinal cord injury in immunohistochemistry. M2 macrophage related markers, Arginase-1 and CD206 mRNA, were increased in the agmatine treatment group and M2 macrophage expressing and stimulated cytokine, IL-10 mRNA, also was significantly overexpressed by agmatine injection. Among BMPs, BMP2/4/7, agmatine significantly increased only the expression of BMP2 known to reduce M1 macrophage under inflammatory status. These results suggest that agmatine reduces impairment after spinal cord injury through modulating the macrophage phenotype.

Diagnostic modalities x-ray and CT chest differ in the management of thoracic injury

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D Chapagain

2015-06-01

Full Text Available Objective: To observe difference in the management of blunt trauma to the chest on the basis of conventional xray and computerised tomography of the chest. Methods: This prospective study was conducted between December 2011 to October 2012 in COMS in Bharatpur,a tertiary referral centre in central Nepal . Clinically stable thoracic injury patients were first evaluated with chest x-ray and the management on this basis was recorded. The findings of the CT chest were assessed and the type of management on the basis of CT was also recorded. Outcome was assessed in terms of mortality, morbidity, hospital and ICU stay with respect to the management on the basis of chest x-ray and CT scan. Results: Of the 129 patients, 74.4% were male and 25.6% were female with the patients ranging in age from 7 to 87 years (mean = 40.41 years. The most common mechanism of trauma to the chest was as a result of a motor vehicle accident (69.8%, followed by fall injury (20.2%. X-ray chest diagnosed rib fracture in 62%, haemothorax in 37%, pneumothorax in 27%, lung contusion in 10% and haemopneumothorax in 21% patients. Similarly CT chest diagnosed rib fracture in 86%, haemothorax in 54%, pneumothorax in 36%, lung contusion in 30% and haemopneumothorax in 30% patients. Mean hospital stay was 9.5 days in the group of patients having management on the basis of x-ray chest relative to mean stay of 10.2 days in the CT- chest group. In the management on the basis of xray group, there was a mean ICU stay of 2.8days compared to mean stays of 3.2 days in CT chest group. Conclusion: Though CT scan of the chest is more informative and differs the management of the blunt chest trauma, one should not forget to advise the cost effective, easily available and initial guiding agent, xray chest for early management of the chest injury patient. DOI: http://dx.doi.org/10.3126/jcmsn.v10i1.12764 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(1; 22-31

Segmental neuropathic pain does not develop in male rats with complete spinal transections.

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Hubscher, Charles H; Kaddumi, Ezidin G; Johnson, Richard D

2008-10-01

In a previous study using male rats, a correlation was found between the development of "at-level" allodynia in T6-7 dermatomes following severe T8 spinal contusion injury and the sparing of some myelinated axons within the core of the lesion epicenter. To further test our hypothesis that this sparing is important for the expression of allodynia and the supraspinal plasticity that ensues, an injury that severs all axons (i.e., a complete spinal cord transection) was made in 15 male rats. Behavioral assessments were done at level throughout the 30-day recovery period followed by terminal electrophysiological recordings (urethane anesthesia) from single medullary reticular formation (MRF) neurons receiving convergent nociceptive inputs from receptive fields above, at, and below the lesion level. None of the rats developed signs of at-level allodynia (versus 18 of 26 male rats following severe contusion). However, the terminal recording (206 MRF neurons) data resembled those obtained previously post-contusion. That is, there was evidence of neuronal hyper-excitability (relative to previous data from intact controls) to high- and low-threshold mechanical stimulation for "at-level" (dorsal trunk) and "above-level" (eyelids and face) cutaneous territories. These results, when combined with prior data on intact controls and severe/moderate contusions, indicate that (1) an anatomically incomplete injury (some lesion epicenter axonal sparing) following severe contusion is likely important for the development of allodynia and (2) the neuronal hyper-excitability at the level of the medulla is likely involved in nociceptive processes that are not directly related to the conscious expression of pain-like avoidance behaviors that are being used as evidence of allodynia.

Bone alterations by stress in athletes

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Doege, H.

1990-01-01

This report describes our experiences with the bone imaging in athletes. We studied 10 athletes and 10 other patients with spondylolisthesis of the lumbar spine and 16 athletes with suspicion of alterations of extremities. An increased uptake of this radiopharmaceutical was detected in six of 10 athletes with spondylolisthesis caused probably by stress fracture. Bone scans were negative in seven of 16 athletes with suspicion of lesion of extremities. In the remaining 9 patients scans were abnormal and showed periosteal injuries, epiphyseal alteration, joint abnormalities, tibial stress fractures and couvert fracture. It was also abnormal in bone injuries not evident in radiography. (orig.) [de

Early application of tail nerve electrical stimulation-induced walking training promotes locomotor recovery in rats with spinal cord injury.

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Zhang, S-X; Huang, F; Gates, M; Shen, X; Holmberg, E G

2016-11-01

This is a randomized controlled prospective trial with two parallel groups. The objective of this study was to determine whether early application of tail nerve electrical stimulation (TANES)-induced walking training can improve the locomotor function. This study was conducted in SCS Research Center in Colorado, USA. A contusion injury to spinal cord T10 was produced using the New York University impactor device with a 25 -mm height setting in female, adult Long-Evans rats. Injured rats were randomly divided into two groups (n=12 per group). One group was subjected to TANES-induced walking training 2 weeks post injury, and the other group, as control, received no TANES-induced walking training. Restorations of behavior and conduction were assessed using the Basso, Beattie and Bresnahan open-field rating scale, horizontal ladder rung walking test and electrophysiological test (Hoffmann reflex). Early application of TANES-induced walking training significantly improved the recovery of locomotor function and benefited the restoration of Hoffmann reflex. TANES-induced walking training is a useful method to promote locomotor recovery in rats with spinal cord injury.

miR-155 Deletion in Mice Overcomes Neuron-Intrinsic and Neuron-Extrinsic Barriers to Spinal Cord Repair.

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Gaudet, Andrew D; Mandrekar-Colucci, Shweta; Hall, Jodie C E; Sweet, David R; Schmitt, Philipp J; Xu, Xinyang; Guan, Zhen; Mo, Xiaokui; Guerau-de-Arellano, Mireia; Popovich, Phillip G

2016-08-10

Axon regeneration after spinal cord injury (SCI) fails due to neuron-intrinsic mechanisms and extracellular barriers including inflammation. microRNA (miR)-155-5p is a small, noncoding RNA that negatively regulates mRNA translation. In macrophages, miR-155-5p is induced by inflammatory stimuli and elicits a response that could be toxic after SCI. miR-155 may also independently alter expression of genes that regulate axon growth in neurons. Here, we hypothesized that miR-155 deletion would simultaneously improve axon growth and reduce neuroinflammation after SCI by acting on both neurons and macrophages. New data show that miR-155 deletion attenuates inflammatory signaling in macrophages, reduces macrophage-mediated neuron toxicity, and increases macrophage-elicited axon growth by ∼40% relative to control conditions. In addition, miR-155 deletion increases spontaneous axon growth from neurons; adult miR-155 KO dorsal root ganglion (DRG) neurons extend 44% longer neurites than WT neurons. In vivo, miR-155 deletion augments conditioning lesion-induced intraneuronal expression of SPRR1A, a regeneration-associated gene; ∼50% more injured KO DRG neurons expressed SPRR1A versus WT neurons. After dorsal column SCI, miR-155 KO mouse spinal cord has reduced neuroinflammation and increased peripheral conditioning-lesion-enhanced axon regeneration beyond the epicenter. Finally, in a model of spinal contusion injury, miR-155 deletion improves locomotor function at postinjury times corresponding with the arrival and maximal appearance of activated intraspinal macrophages. In miR-155 KO mice, improved locomotor function is associated with smaller contusion lesions and decreased accumulation of inflammatory macrophages. Collectively, these data indicate that miR-155 is a novel therapeutic target capable of simultaneously overcoming neuron-intrinsic and neuron-extrinsic barriers to repair after SCI. Axon regeneration after spinal cord injury (SCI) fails due to neuron

miR-155 Deletion in Mice Overcomes Neuron-Intrinsic and Neuron-Extrinsic Barriers to Spinal Cord Repair

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Mandrekar-Colucci, Shweta; Hall, Jodie C.E.; Sweet, David R.; Schmitt, Philipp J.; Xu, Xinyang; Guan, Zhen; Mo, Xiaokui; Guerau-de-Arellano, Mireia

2016-01-01

Axon regeneration after spinal cord injury (SCI) fails due to neuron-intrinsic mechanisms and extracellular barriers including inflammation. microRNA (miR)-155–5p is a small, noncoding RNA that negatively regulates mRNA translation. In macrophages, miR-155-5p is induced by inflammatory stimuli and elicits a response that could be toxic after SCI. miR-155 may also independently alter expression of genes that regulate axon growth in neurons. Here, we hypothesized that miR-155 deletion would simultaneously improve axon growth and reduce neuroinflammation after SCI by acting on both neurons and macrophages. New data show that miR-155 deletion attenuates inflammatory signaling in macrophages, reduces macrophage-mediated neuron toxicity, and increases macrophage-elicited axon growth by ∼40% relative to control conditions. In addition, miR-155 deletion increases spontaneous axon growth from neurons; adult miR-155 KO dorsal root ganglion (DRG) neurons extend 44% longer neurites than WT neurons. In vivo, miR-155 deletion augments conditioning lesion-induced intraneuronal expression of SPRR1A, a regeneration-associated gene; ∼50% more injured KO DRG neurons expressed SPRR1A versus WT neurons. After dorsal column SCI, miR-155 KO mouse spinal cord has reduced neuroinflammation and increased peripheral conditioning-lesion-enhanced axon regeneration beyond the epicenter. Finally, in a model of spinal contusion injury, miR-155 deletion improves locomotor function at postinjury times corresponding with the arrival and maximal appearance of activated intraspinal macrophages. In miR-155 KO mice, improved locomotor function is associated with smaller contusion lesions and decreased accumulation of inflammatory macrophages. Collectively, these data indicate that miR-155 is a novel therapeutic target capable of simultaneously overcoming neuron-intrinsic and neuron-extrinsic barriers to repair after SCI. SIGNIFICANCE STATEMENT Axon regeneration after spinal cord injury (SCI) fails

MRI after patellar dislocation. Assessment of risk factors and injury to the joint

International Nuclear Information System (INIS)

Diederichs, G.

2013-01-01

Patellar dislocation is the lateral displacement of the patella from the femoral trochlea. Affected individuals typically have underlying anatomic risk factors of variable magnitude, which, in conjunction with leg rotation, cause the event. Magnetic resonance imaging (MRI) permits straightforward diagnosis of the typical features of recent patellar dislocation: contusion edema of the inferomedial patella and the lateral femoral condyle as well as rupture of the medial patellofemoral ligament. In case of concomitant osteochondral injury, early surgical refixation may be indicated, depending on the size. After a first dislocation, which can damage the capsuloligamentous stabilizers, subjects may sustain further dislocations or even develop chronic patellofemoral instability, depending on the presence and severity of anatomic variants. A wide range of conservative and surgical treatments are available. While a first patellar dislocation is often treated conservatively, surgical strategies after a second dislocation depend on the pattern of injury and the severity of underlying anatomic risk factors. The most relevant predisposing variants are trochlear dysplasia, patella alta, and an abnormal tibial tubercle to trochlear groove distance (TT-TG). The radiologist's report should give a quantitative estimate of both the injuries resulting from dislocation and the underlying anatomic risk factors. An accurate characterization of the individual pathomechanism is crucial for tailoring treatment. (orig.)

A comparison of wakeboard-, water skiing-, and tubing-related injuries in the United States, 2000-2007.

Science.gov (United States)

Baker, John I; Griffin, Russell; Brauneis, Paul F; Rue, Loring W; McGwin, Gerald

2010-01-01

The purpose of the study was to compare tubing-related injuries to wakeboarding- and water skiing-related injuries. Data was collected from the 2000-2007 National Electronic Injury Surveillance Survey for 1,761 individuals seeking care at an emergency department due to a tubing-, wakeboarding, or water skiing-related injury. Data included patient age and sex, as well as injury characteristics including body region injured (i.e., head and neck, trunk, shoulder and upper extremity, and hip and lower extremity) and diagnosis of injury (e.g., contusion, laceration, or fracture). Case narratives were reviewed to ensure that a tubing-, wakeboarding-, or water skiing-related injury occurred while the individual was being towed behind a boat. Severe injury (defined as an injury resulting in the individual being hospitalized, transferred, held for observation) was compared among the groups using logistic regression. Wakeboard- and tubing-related injuries more commonly involved the head and neck, while water skiing- related injuries were likely to involve the hip and lower extremity. Tubing-related injuries, compared to water skiing-related injuries, were more likely to be severe (OR 2.31, 95% CI 1.23-4. 33). Like wakeboarding and water skiing, tubing has inherent risks that must be understood by the participant. While tubing is generally considered a safer alternative to wakeboarding and water skiing, the results of the current study suggest otherwise. Both the number and severity of tubing- related injuries could be prevented through means such as advocating the use of protective wear such as helmets while riding a tube or having recommended safe towing speeds prominently placed on inner tubes. Key pointsIncrease annual injury rate trend in wakeboard injuries.Wakeboard- and tubing-related injuries more often to head and neck, waterskiing-related injuries more often to hip and lower extremity.Tubing-related injuries over 2-times as likely to be severe compared to

Experience with contrast-enhanced CT in delayed traumatic intracerebral hematoma

Energy Technology Data Exchange (ETDEWEB)

Kobayashi, Shiro; Nakazawa, Shozo; Yokota, Hiroyuki; Isayama, Kazuo; Yajima, Kouzo; Otsuka, Toshibumi [Nippon Medical School, Tokyo

1984-02-01

During the four-and-a-half-year period from April, 1976, to September, 1980, out of 257 patients with severe head injuries graded 8 or less by the Glasgow Coma Scale in the Department of Neurosurgery and Critical Care Medicine of the Nippon Medical School, Tokyo, Japan, 33 cases showed the development of delayed traumatic intracerebral hematoma (DTICH) upon the serial computerized tomography (CT). Contrast-enhanced CT was performed in 20 cases of the 33 patients demonstrating DTICH. Among these, 8 cases (40%) indicated the development of DTICH in the lesions of cerebral contusion (a salt-and-pepper appearance in the initial plain CT) which showed a remarkable enhancement, sustaining the extravasation of the contrast medium into the contused brain tissue. The authors discuss the pathogenesis of DTICH and suggest that vasoparalysis in the cerebral contusion might be a factor in the development of DTICH in patients with servere head injuries.

Epidemiology of Youth Boys' and Girls' Lacrosse Injuries in the 2015 to 2016 Seasons.

Science.gov (United States)

Kerr, Zachary Y; Lincoln, Andrew E; Dodge, Thomas; Yeargin, Susan W; Covassin, Tracey M; Nittoli, Vincent C; Mensch, James; Roos, Karen G; Dompier, Thomas P; Caswell, Shane V

2018-02-01

Examinations of injury among younger populations of lacrosse players that are beginning their development is limited. This study describes the epidemiology of youth boys' and girls' lacrosse injuries during the 2015 to 2016 seasons. Surveillance data originated from a convenience sample of 10 leagues in five states with 1090 boy lacrosse players and 408 girl lacrosse players from the U9-U15 divisions. Athletic trainers reported injury and exposure data at games and practices. Time loss (TL) injuries were defined as resulting in ≥24 h of participation restriction time. Injury counts and rates per 1000 athlete games/practices were calculated. Injury rate ratios (IRR) with 95% confidence intervals (CI) compared rates by sex and age division. Overall, 241 and 59 injuries were reported in boys' and girls' youth lacrosse, respectively, of which 17.0% and 18.6% were TL. Compared with girls, boys had a higher overall injury rate (12.7 vs 8.7/1000 athlete games/practices; IRR, 1.5; 95% CI, 1.1-1.9). U13/U15 boys had a higher TL injury rate than U9/U11 boys (2.6 vs 1.0/1000 athlete game/practices; IRR, 2.6; 95% CI, 1.1-6.1). Most injuries were diagnosed as contusions (boys, 53.7%; girls, 47.2%) and resulted from stick contact (boys, 34.1%; girls, 30.6%) and ball contact (boys, 17.1%; girls, 25.0%). Among girls, ball contact contributed to 75.0% (n = 9) of all head/face injuries. Among the 14 concussions reported in boys, player contact was the most common injury mechanism (50.0%, n = 7), followed by stick contact (35.7%, n = 5). Boys' lacrosse has a higher injury incidence than girls' lacrosse, reflecting the contact nature of the boys' game. The high incidence of stick- and ball-related injuries suggests the need for youth-specific rules to better protect youth players.

[Injury patterns and roentgen findings in gunshot wounds with rare flint ammunition].

Science.gov (United States)

Pollak, S; Lindermann, A

1990-01-01

Smoothbore shotgun barrels can fire cartridges with common pellet loads as well as shotgun slugs and rubber bullets. Other than conventional shot, the cylindrical Brenneke-type rifled shotgun slugs sometimes cause perforating wounds. The shotgun ammunition for use in self-defence can have a single projectile or several rubber pellets. Where the propellant is black powder, short range shots will probably leave searing marks and intensive soot deposits. Fired at close range, rubber bullets can penetrate through the skin into the body, fired at greater distance they cause contusions. A case of homicide (repeated firing with a 12-ga. pump gun) is used to present and discuss the injury patterns and X-ray findings after impact of Brenneke-type slugs and rubber bullets as well as of "classical" shot pellets.

Magnetic susceptibility artifacts in a diffuse brain injury and their pathological significance

International Nuclear Information System (INIS)

Taguchi, Yoshio; Miyakita, Yasuji; Matsuzawa, Motoshi; Sakakibara, Yohtaro; Takahara, Taro; Yamaguchi, Toshio

1998-01-01

In our study, FLAIR images and multishot echo planar imaging T2-weighted images (EPI T2-WI) were used in addition to conventional T1-weighted images, T2-weighted images and T2-weighted sagittal images. In this series we focused our attention on small parenchymatous lesions of a mild or moderate form of diffuse brain injury. These injuries are shown as high intensity areas on T2-weighted images (T2-high intensity lesions) but are not visualized in CT images. This series consisted of 29 patients who were diagnosed with diffuse brain injury and whose CT scans showed a Diffuse Injury I or II. Nineteen patients were studied in an acute or subacute stage. In all but 3 patients, small T2-high intensity lesions were found in the brain parenchyma. In the follow-up study brain edema was suggested because the lesions tended to be absent within 3 months in T2-weighted images and FLAIR. In 10 patients examined during a chronic stage. Small hemorrhages in patients with Diffuse Injury II were shown with variable intensities on the conventional T1- and T2-weighted images, but were visualized with low intensity in an EPI T2-WI. In diffuse brain injuries, small T2-high intensity lesions have been considered to be brain edema or ischemic insults. Our data however, suggested that microhemorrhages associated with brain edema were resent in most of the supratentorial lesions, and in more than a half of the lesions in the corpus callosum and the brain stem. These findings appear similar to contusions, which are defined as traumatic bruises of the neural parenchyma. The use of MRI has increased our understanding of in vivo pathological changes in mild or moderate forms of diffuse brain injury. (K.H.)

Comparison of {sup 99m}Tc-HMPAO SPECT and MRI after Acute and Subacute Closed-Head Injury

Energy Technology Data Exchange (ETDEWEB)

Yoo, Won Jong; Lee, Sang Hoon; Sohn, Hyung Sun; Lee, Han Jin; Park, Jeong Mi; Chung, Soo Kyo; Kim, Choon Yul; Bahk, Yong Whee; Shin, Kyung Sub [Catholic University College of Medicine, Seoul (Korea, Republic of)

1994-10-15

The purpose of this study was to compare {sup 99m}Tc-HMPAO SPECT with MRI after acute and subacute closed head injury. There were thirty two focal lesions in all cases of these, Fifteen lesions(47%) were seen on both MRI and SPECT. Fourteen lesions(44%) were seen only on MRI. Three lesions(9%) were seen only on SPECT. Of the 14 lesions seen only on MRl, one was epidural hematoma, two were subdural hematoma, three were subdural hygroma, one was intracerebral hematoma, four were contusion, and three were diffuse axonal injuries. SPECT detected 52% of the focal lesions found on MRI. For the detection of lesions, MRl was superior to SPECT in fourteen cases, while SPECT was superior to MRI in three cases. In conclusion, there was a tendency that detection rate of the traumatic lesions was higher on MRI, but the SPECT could delineate more wide extent of lesion.

Chest Trauma in Athletic Medicine.

Science.gov (United States)

Phillips, Nicholas R; Kunz, Derek E

2018-03-01

While overall sports participation continues at high rates, chest injuries occur relatively infrequently. Many conditions of chest injury are benign, related to simple contusions and strains, but the more rare, severe injuries carry a much higher risk of morbidity and mortality than the typical issues encountered in athletic medicine. Missed or delayed diagnosis can prove to be catastrophic. Sports medicine providers must be prepared to encounter a wide range of traumatic conditions relating to the torso, varying from the benign chest wall contusion to the life-threatening tension pneumothorax. Basic field-side management should be rapid and focused, using the standardized approach of Advanced Traumatic Life Support protocol. Early and appropriate diagnosis and management can help allow safe and enjoyable sports participation.

Suicide after traumatic brain injury: a population study

DEFF Research Database (Denmark)

Teasdale, T W; Engberg, A W

2001-01-01

OBJECTIVES: To determine the rates of suicide among patients who have had a traumatic brain injury. METHODS: From a Danish population register of admissions to hospital covering the years 1979-93 patients were selected who had had either a concussion (n=126 114), a cranial fracture (n=7560......), or a cerebral contusion or traumatic intracranial haemorrhage (n=11 766). All cases of deaths by the end of the study period were identified. RESULTS: In the three diagnostic groups there had been 750 (0.59%), 46 (0.61%), and 99 (0.84%) cases of suicide respectively. Standardised mortality ratios, stratified...... by sex and age, showed that the incidence of suicide among the three diagnostic groups was increased relative to the general population (3.0, 2.7, and 4.1 respectively). In all diagnosis groups the ratios were higher for females than for males, and lower for patients injured before the age of 21 or after...

Beach handball is safer than indoor team handball: injury rates during the 2017 European Beach Handball Championships.

Science.gov (United States)

Achenbach, Leonard; Loose, Oliver; Laver, Lior; Zeman, Florian; Nerlich, Michael; Angele, Peter; Krutsch, Werner

2018-03-28

Beach handball is a relatively new type of sports, which was derived from team handball. Medical issues such as frequency and severity of injury are yet unknown. The purpose of this study was to investigate the injury pattern and injury rates of this new type of sports. This study investigated the injury incidence of 30 national teams (10 senior and 20 u-17 teams, 16 men's and 14 women's teams) participating in the 2017 European Beach Handball Championships. Reports on injuries sustained during the senior and u-17 youth tournaments were provided by the medical staff of each team. Injury incidence was differentiated between age and sex, and between the five field positions (goalkeeper, wing, central defender, pivot, and specialist). During the tournaments, 87 injuries were recorded yielding an overall injury incidence of 286.1 per 1000 match hours. Time-loss due to injury was 49.3 per 1000 match hours. Senior players had a higher overall injury incidence with 395.3 injuries than u-17 players with 205.7 injuries per 1000 h match hours (p handball exposure for male players and 234.9 injuries for female players (n.s.). The most frequent injury type was sprains (21 injuries, 24.1%) followed by contusions (19 injuries, 21.8%) and skin abrasions with (15 injuries, 17.2%). Central defenders and specialists had the highest injury incidence. Thighs, ankles, as well as foot and toes (altogether 12 injuries, all 13.8%) were the three most frequently injured anatomic sites. Beach handball seems to have a lower incidence of time-loss injuries than that reported for indoor team handball. This study is an important basis for developing injury prevention strategies in this sports that should focus on thighs, ankles, feet and toes. Further research into this new type of sports is essential to identify risk factors and to develop adequate injury prevention measures. II.

Comparison of Injuries in American Collegiate Football and Club Rugby: A Prospective Cohort Study.

Science.gov (United States)

Willigenburg, Nienke W; Borchers, James R; Quincy, Richard; Kaeding, Christopher C; Hewett, Timothy E

2016-03-01

American football and rugby players are at substantial risk of injury because of the full-contact nature of these sports. Methodological differences between previous epidemiological studies hamper an accurate comparison of injury rates between American football and rugby. To directly compare injury rates in American collegiate football and rugby, specified by location, type, mechanism, and severity of injury, as reported by licensed medical professionals. Cohort study; Level of evidence, 2. Licensed medical professionals (athletic trainer or physician) associated with the football and rugby teams of a National Collegiate Athletic Association Division I university reported attendance and injury details over 3 autumn seasons. Injuries were categorized by the location, type, mechanism, and severity of injury, and the injury rate was calculated per 1000 athlete-exposures (AEs). Injury rate ratios (IRRs) were calculated to compare overall, game, and practice injury rates within and between sports. The overall injury rate was 4.9/1000 AEs in football versus 15.2/1000 AEs in rugby: IRR = 3.1 (95% CI, 2.3-4.2). Game injury rates were higher than practice injury rates: IRR = 6.5 (95% CI, 4.5-9.3) in football and IRR = 5.1 (95% CI, 3.0-8.6) in rugby. Injury rates for the shoulder, wrist/hand, and lower leg and for sprains, fractures, and contusions in rugby were >4 times as high as those in football (all P ≤ 0.006). Concussion rates were 1.0/1000 AEs in football versus 2.5/1000 AEs in rugby. Most injuries occurred via direct player contact, especially during games. The rate of season-ending injuries (>3 months of time loss) was 0.8/1000 AEs in football versus 1.0/1000 AEs in rugby: IRR = 1.3 (95% CI, 0.4-3.4). Overall injury rates were substantially higher in collegiate rugby compared with football. Similarities between sports were observed in the most common injury types (sprains and concussions), locations (lower extremity and head), and mechanisms (direct player contact

Spinal Cord Swelling and Alterations in Hydrostatic Pressure After Acute Injury

Science.gov (United States)

2017-10-01

within four weeks following injury, and 3) neurologic level of injury at or below C8. The rational for the selection of low cervical /high thoracic...Brain : a journal of neurology 2002;125(Pt 11):2567–2578. 4. Jutzeler CR, Huber E, Callaghan MF, et al. Association of pain and CNS structural...changes after spinal cord injury. Scientific Reports 2016;6 5. Jutzeler CR, Curt A, Kramer JLK. Relationship between chronic pain and brain

Calcium channel alpha-2-delta-1 protein upregulation in dorsal spinal cord mediates spinal cord injury-induced neuropathic pain states.

Science.gov (United States)

Boroujerdi, Amin; Zeng, Jun; Sharp, Kelli; Kim, Donghyun; Steward, Oswald; Luo, Z David

2011-03-01

Spinal cord injury (SCI) commonly results in the development of neuropathic pain, which can dramatically impair the quality of life for SCI patients. SCI-induced neuropathic pain can be manifested as both tactile allodynia (a painful sensation to a non-noxious stimulus) and hyperalgesia (an enhanced sensation to a painful stimulus). The mechanisms underlying these pain states are poorly understood. Clinical studies have shown that gabapentin, a drug that binds to the voltage-gated calcium channel alpha-2-delta-1 subunit (Ca(v)α2δ-1) proteins is effective in the management of SCI-induced neuropathic pain. Accordingly, we hypothesized that tactile allodynia post SCI is mediated by an upregulation of Ca(v)α2δ-1 in dorsal spinal cord. To test this hypothesis, we examined whether SCI-induced dysregulation of spinal Ca(v)α2δ-1 plays a contributory role in below-level allodynia development in a rat spinal T9 contusion injury model. We found that Ca(v)α2δ-1 expression levels were significantly increased in L4-6 dorsal, but not ventral, spinal cord of SCI rats that correlated with tactile allodynia development in the hind paw plantar surface. Furthermore, both intrathecal gabapentin treatment and blocking SCI-induced Ca(v)α2δ-1 protein upregulation by intrathecal Ca(v)α2δ-1 antisense oligodeoxynucleotides could reverse tactile allodynia in SCI rats. These findings support that SCI-induced Ca(v)α2δ-1 upregulation in spinal dorsal horn is a key component in mediating below-level neuropathic pain states, and selectively targeting this pathway may provide effective pain relief for SCI patients. Spinal cord contusion injury caused increased calcium channel Ca(v)α2δ-1 subunit expression in dorsal spinal cord that contributes to neuropathic pain states. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Subtoxic Alterations in Hepatocyte-Derived Exosomes: An Early Step in Drug-Induced Liver Injury?

Science.gov (United States)

Holman, Natalie S; Mosedale, Merrie; Wolf, Kristina K; LeCluyse, Edward L; Watkins, Paul B

2016-06-01

Drug-induced liver injury (DILI) is a significant clinical and economic problem in the United States, yet the mechanisms that underlie DILI remain poorly understood. Recent evidence suggests that signaling molecules released by stressed hepatocytes can trigger immune responses that may be common across DILI mechanisms. Extracellular vesicles released by hepatocytes, principally hepatocyte-derived exosomes (HDEs), may constitute one such signal. To examine HDE alterations as a function of drug-induced stress, this work utilized prototypical hepatotoxicant acetaminophen (APAP) in male Sprague-Dawley (SD) rats, SD rat hepatocytes, and primary human hepatocytes. HDE were isolated using ExoQuick precipitation reagent and analyzed by quantification of the liver-specific RNAs albumin and microRNA-122 (miR-122). In vivo, significant elevations in circulating exosomal albumin mRNA were observed at subtoxic APAP exposures. Significant increases in exosomal albumin mRNA were also observed in primary rat hepatocytes at subtoxic APAP concentrations. In primary human hepatocytes, APAP elicited increases in both exosomal albumin mRNA and exosomal miR-122 without overt cytotoxicity. However, the number of HDE produced in vitro in response to APAP did not increase with exosomal RNA quantity. We conclude that significant drug-induced alterations in the liver-specific RNA content of HDE occur at subtoxic APAP exposures in vivo and in vitro, and that these changes appear to reflect selective packaging rather than changes in exosome number. The current findings demonstrate that translationally relevant HDE alterations occur in the absence of overt hepatocellular toxicity, and support the hypothesis that HDE released by stressed hepatocytes may mediate early immune responses in DILI. © The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Extent, nature and hospital costs of fireworks-related injuries during the Wednesday Eve festival in Iran.

Science.gov (United States)

Alinia, Siros; Rezaei, Satar; Daroudi, Rajabali; Hadadi, Mashyaneh; Akbari Sari, Ali

2013-01-01

Fireworks are commonly used in local and national celebrations. The aim of this study is to explore the extent, nature and hospital costs of injuries related to the Persian Wednesday Eve festival in Iran. Data for injuries caused by fireworks during the 2009 Persian Wednesday Eve festival were collected from the national Ministry of Health database. Injuries were divided into nine groups and the average and total hospital costs were estimated for each group. The cost of care for patients with burns was estimated by reviewing a sample of 100 patients randomly selected from a large burn center in Tehran. Other costs were estimated by conducting semi structured interviews with expert managers at two large government hospitals. 1817 people were injured by fireworks during the 2009 Wednesday Eve festival. The most frequently injured sites were the hand (43.3%), eye (24.5%) and face (13.2%), and the most common types of injury were burns (39.9%), contusions/abrasions (24.6%) and lacerations (12.7%). The mean length of hospital stay was 8.15 days for patients with burns, 10.7 days for those with amputations, and 3 days for those with other types of injury. The total hospital cost of injuries was US$ 284 000 and the average cost per injury was US$ 156. The total hospital cost of patients with amputations was US$ 48 598. Most of the costs were related to burns (56.6%) followed by amputations (12.2%). Injuries related to the Persian Wednesday Eve festival are common and lead to extensive morbidity and medical costs. © 2013 KUMS, All rights reserved.

Local delivery of thyroid hormone enhances oligodendrogenesis and myelination after spinal cord injury

Science.gov (United States)

Shultz, Robert B.; Wang, Zhicheng; Nong, Jia; Zhang, Zhiling; Zhong, Yinghui

2017-06-01

Objective. Traumatic spinal cord injury (SCI) causes apoptosis of myelin-forming oligodendrocytes (OLs) and demyelination of surviving axons, resulting in conduction failure. Remyelination of surviving denuded axons provides a promising therapeutic target for spinal cord repair. While cell transplantation has demonstrated efficacy in promoting remyelination and functional recovery, the lack of ideal cell sources presents a major obstacle to clinical application. The adult spinal cord contains oligodendrocyte precursor cells and multipotent neural stem/progenitor cells that have the capacity to differentiate into mature, myelinating OLs. However, endogenous oligodendrogenesis and remyelination processes are limited by the upregulation of remyelination-inhibitory molecules in the post-injury microenvironment. Multiple growth factors/molecules have been shown to promote OL differentiation and myelination. Approach. In this study we screened these therapeutics and found that 3, 3‧, 5-triiodothyronine (T3) is the most effective in promoting oligodendrogenesis and OL maturation in vitro. However, systemic administration of T3 to achieve therapeutic doses in the injured spinal cord is likely to induce hyperthyroidism, resulting in serious side effects. Main results. In this study we developed a novel hydrogel-based drug delivery system for local delivery of T3 to the injury site without eliciting systemic toxicity. Significance. Using a clinically relevant cervical contusion injury model, we demonstrate that local delivery of T3 at doses comparable to safe human doses promoted new mature OL formation and myelination after SCI.

Spatial and temporal expression levels of specific microRNAs in a spinal cord injury mouse model and their relationship to the duration of compression.

Science.gov (United States)

Ziu, Mateo; Fletcher, Lauren; Savage, Jennifer G; Jimenez, David F; Digicaylioglu, Murat; Bartanusz, Viktor

2014-02-01

MicroRNAs, a class of small nonprotein-coding RNAs, are thought to control gene translation into proteins. The latter are the ultimate effectors of the biochemical cascade occurring in any physiological and pathological process. MicroRNAs have been shown to change their expression levels during injury of spinal cord in contusion rodent models. Compression is the most frequent mode of damage of neural elements in spinal cord injury. The cellular and molecular changes occurring in the spinal cord during prolonged compression are not very well elucidated. Understanding the underlying molecular events that occur during sustained compression is paramount in building new therapeutic strategies. The purpose of our study was to probe the relationship between the expression level changes of different miRNAs and the timing of spinal cord decompression in a mouse model. A compression spinal cord injury mouse model was used for the study. A laminectomy was performed in the thoracic spine of C57BL/6 mice. Then, the thecal sac was compressed to create the injury. Decompression was performed early for one group and it was delayed in the second group. The spinal cord at the epicenter of the injury and one level rostral to it were removed at 3, 6, and 24 hours after trauma, and RNA was extracted. Expression levels of six different microRNAs and the relationship to the duration of compression were analyzed. This work was supported in part by the University Research Council Grants Program at the University of Texas Health Science Center San Antonio (Grant 130267). There are no specific conflicts of interest to be disclosed for this work. Expression levels of microRNAs in the prolonged compression of spinal cord model were significantly different compared with the expression levels in the short duration of compression spinal cord injury model. Furthermore, microRNAs show a different expression pattern in different regions of the injured spinal cord. Our findings demonstrate that

Experience with contrast-enhanced CT in delayed traumatic intracerebral hematoma

International Nuclear Information System (INIS)

Kobayashi, Shiro; Nakazawa, Shozo; Yokota, Hiroyuki; Isayama, Kazuo; Yajima, Kouzo; Otsuka, Toshibumi

1984-01-01

During the four-and-a-half-year period from April, 1976, to September, 1980, out of 257 patients with severe head injuries graded 8 or less by the Glasgow Coma Scale in the Department of Neurosurgery and Critical Care Medicine of the Nippon Medical School, Tokyo, Japan, 33 cases showed the development of delayed traumatic intracerebral hematoma (DTICH) upon the serial computerized tomography (CT). Contrast-enhanced CT was performed in 20 cases of the 33 patients demonstrating DTICH. Among these, 8 cases (40%) indicated the development of DTICH in the lesions of cerebral contusion (a salt-and-pepper appearance in the initial plain CT) which showed a remarkable enhancement, sustaining the extravasation of the contrast medium into the contused brain tissue. The authors discuss the pathogenesis of DTICH and suggest that vasoparalysis in the cerebral contusion might be a factor in the development of DTICH in patients with servere head injuries. (author)

Brain injury and altered brain growth in preterm infants: predictors and prognosis.

Science.gov (United States)

Kidokoro, Hiroyuki; Anderson, Peter J; Doyle, Lex W; Woodward, Lianne J; Neil, Jeffrey J; Inder, Terrie E

2014-08-01

To define the nature and frequency of brain injury and brain growth impairment in very preterm (VPT) infants by using MRI at term-equivalent age and to relate these findings to perinatal risk factors and 2-year neurodevelopmental outcomes. MRI scans at term-equivalent age from 3 VPT cohorts (n = 325) were reviewed. The severity of brain injury, including periventricular leukomalacia and intraventricular and cerebellar hemorrhage, was graded. Brain growth was assessed by using measures of biparietal width (BPW) and interhemispheric distance. Neurodevelopmental outcome at age 2 years was assessed across all cohorts (n = 297) by using the Bayley Scales of Infant Development, Second Edition (BSID-II) or Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III), and evaluation for cerebral palsy. Of 325 infants, 107 (33%) had some grade of brain injury and 33 (10%) had severe injury. Severe brain injury was more common in infants with lower Apgar scores, necrotizing enterocolitis, inotropic support, and patent ductus arteriosus. Severe brain injury was associated with delayed cognitive and motor development and cerebral palsy. Decreased BPW was related to lower gestational age, inotropic support, patent ductus arteriosus, necrotizing enterocolitis, prolonged parenteral nutrition, and oxygen at 36 weeks and was associated with delayed cognitive development. In contrast, increased interhemispheric distance was related to male gender, dexamethasone use, and severe brain injury. It was also associated with reduced cognitive development, independent of BPW. At term-equivalent age, VPT infants showed both brain injury and impaired brain growth on MRI. Severe brain injury and impaired brain growth patterns were independently associated with perinatal risk factors and delayed cognitive development. Copyright © 2014 by the American Academy of Pediatrics.

Neurologic Outcome of Laminoplasty for Acute Traumatic Spinal Cord Injury without Instability.

Science.gov (United States)

Lee, Hwa Joong; Kim, Hwan Soo; Nam, Kyoung Hyup; Han, In Ho; Cho, Won Ho; Choi, Byung Kwan

2013-09-01

The purpose of this study is to evaluate the efficacy of laminoplasty in the treatment of spinal cord injury (SCI) without instability. 79 patients with SCI without instability who underwent surgical treatment in our institute between January 2005 and September 2012 were retrospectively reviewed. Twenty nine patients fulfilled the inclusion criteria as follows: SCI without instability, spinal cord contusion in MRI, cervical stenosis more than 20%, follow up at least 6 months. Preoperative neurological state, clinical outcome and neurological function was measured using the American Spinal Injury Association (ASIA) impairment scale, modified Japanese Orthopedic Association (mJOA) grading scale and Hirabayashi recovering rate. Seventeen patients showed improvement in ASIA grade and twenty six patients showed improvement in mJOA scale at 6 month follow up. However, all patients with ASIA grade B and C have shown improvement of one or more ASIA grade. Mean Hirabayashi recovery rate was 47.4±23.7%. There was better neurologic recovery in those who had cervical spondylosis without ossification of posterior longitudinal ligament (OPLL) (pcervical canal stenosis, especially spondylosis without OPLL and neurologic deterioration in ASIA B, C and D.

Contemporary management of flail chest.

Science.gov (United States)

Vana, P Geoff; Neubauer, Daniel C; Luchette, Fred A

2014-06-01

Thoracic injury is currently the second leading cause of trauma-related death and rib fractures are the most common of these injuries. Flail chest, as defined by fracture of three or more ribs in two or more places, continues to be a clinically challenging problem. The underlying pulmonary contusion with subsequent inflammatory reaction and right-to-left shunting leading to hypoxia continues to result in high mortality for these patients. Surgical stabilization of the fractured ribs remains controversial. We review the history of management for flail chest alone and when combined with pulmonary contusion. Finally, we propose an algorithm for nonoperative and surgical management.

Brain Contusion and Cervical Fracture in a Professional Boxer.

Science.gov (United States)

Jordan, Barry D.; And Others

1988-01-01

This case study of an injury sustained by a 22-year old boxer who was knocked out in the ring demonstrates two aspects of medical care for boxers: the potential for cervical spine fracture and the importance of ringside emergency medical services. The injury, diagnosis, and treatment are discussed. (Author/JL)

Experimental spinal cord trauma: a review of mechanically induced spinal cord injury in rat models.

Science.gov (United States)

Abdullahi, Dauda; Annuar, Azlina Ahmad; Mohamad, Masro; Aziz, Izzuddin; Sanusi, Junedah

2017-01-01

It has been shown that animal spinal cord compression (using methods such as clips, balloons, spinal cord strapping, or calibrated forceps) mimics the persistent spinal canal occlusion that is common in human spinal cord injury (SCI). These methods can be used to investigate the effects of compression or to know the optimal timing of decompression (as duration of compression can affect the outcome of pathology) in acute SCI. Compression models involve prolonged cord compression and are distinct from contusion models, which apply only transient force to inflict an acute injury to the spinal cord. While the use of forceps to compress the spinal cord is a common choice due to it being inexpensive, it has not been critically assessed against the other methods to determine whether it is the best method to use. To date, there is no available review specifically focused on the current compression methods of inducing SCI in rats; thus, we performed a systematic and comprehensive publication search to identify studies on experimental spinalization in rat models, and this review discusses the advantages and limitations of each method.

Incidência de lesão musculoesquelética em jogadores de futebol Incidence of musculoskeletal injury in soccer players

Directory of Open Access Journals (Sweden)

Pedro Sávio Macedo de Almeida

2013-04-01

Full Text Available INTRODUÇÃO: Sendo o futebol um esporte de grande popularidade em todo o mundo e principalmente no Brasil, vários estudos procuram formar um perfil das lesões e dos jogadores mais propensos a elas; porém, este tipo de estudo é raro na região norte do País. OBJETIVO: Analisar a incidência de lesões musculoesqueléticas nos jogadores de futebol profissional do Clube do Remo, Belém, PA. MÉTODOS: Foram analisados 27 jogadores de futebol profissional do Clube do Remo, durante o Campeonato Paraense de futebol de 2010. Os dados foram coletados através da verificação dos prontuários e aplicação de um questionário semicodificado para os atletas; posteriormente foi realizada a análise estatística. RESULTADOS: Ao analisar a amostra, verificou-se que a maioria das lesões foi de contraturas e contusões, os locais corpóreos mais acometidos foram a coxa e o joelho e a posição em campo mais lesionada foi a de meio de campo. CONCLUSÃO: Ocorreram várias lesões musculares; por isso, é necessário um acompanhamento da equipe multiprofissional, já que este tipo de lesão não ocorre devido a trauma e sim pelos movimentos que os jogadores são impostos durante os jogos e treinos.INTRODUCTION: Due to soccer worldwide popularity, especially in Brazil, several studies try to outline a profile of injuries and players more prone to it; however, this kind of study is rare in the northern region of our country. OBJETIVE: To analyze the incidence of musculoskeletal injuries on professional soccer players of Remo Club. METHODS: We analyzed 27 professional soccer players of Remo Club were analyzed during the Soccer Championship from Pará State, 2010. Data were collected through verification of records and application of a semi-coded questionnaire to the athletes; subsequently, statistical analysis was conducted. RESULTS: By analyzing the sample, it was found that most of the injuries were contractures and contusions (bruises, the body parts most

Altered spontaneous brain activity in patients with acute spinal cord injury revealed by resting-state functional MRI.

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Ling Zhu

Full Text Available Previous neuroimaging studies have provided evidence of structural and functional reorganization of brain in patients with chronic spinal cord injury (SCI. However, it remains unknown whether the spontaneous brain activity changes in acute SCI. In this study, we investigated intrinsic brain activity in acute SCI patients using a regional homogeneity (ReHo analysis based on resting-state functional magnetic resonance imaging.A total of 15 patients with acute SCI and 16 healthy controls participated in the study. The ReHo value was used to evaluate spontaneous brain activity, and voxel-wise comparisons of ReHo were performed to identify brain regions with altered spontaneous brain activity between groups. We also assessed the associations between ReHo and the clinical scores in brain regions showing changed spontaneous brain activity.Compared with the controls, the acute SCI patients showed decreased ReHo in the bilateral primary motor cortex/primary somatosensory cortex, bilateral supplementary motor area/dorsal lateral prefrontal cortex, right inferior frontal gyrus, bilateral dorsal anterior cingulate cortex and bilateral caudate; and increased ReHo in bilateral precuneus, the left inferior parietal lobe, the left brainstem/hippocampus, the left cingulate motor area, bilateral insula, bilateral thalamus and bilateral cerebellum. The average ReHo values of the left thalamus and right insula were negatively correlated with the international standards for the neurological classification of spinal cord injury motor scores.Our findings indicate that acute distant neuronal damage has an immediate impact on spontaneous brain activity. In acute SCI patients, the ReHo was prominently altered in brain regions involved in motor execution and cognitive control, default mode network, and which are associated with sensorimotor compensatory reorganization. Abnormal ReHo values in the left thalamus and right insula could serve as potential biomarkers for

CT of blunt chest trauma in children

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Manson, D.; Babyn, P.S.; Palder, S.; Bergmann, K.

1993-01-01

While trauma is still the leading cause of death in the pediatric age range, it is surprising how little the CT appearances of pediatric chest injury have been investigated in the literature. We have reviewed the CT findings of blunt chest trauma in 44 children for whom chest CT examinations were requested to investigate the extent of intrathoracic injury. We noted a propensity for pulmonary contusions to be located posteriorly or posteromedially, and for them to be anatomically nonsegmental and crescentic in shape. This is possibly attributable to the relatively compliant anterior chest wall in children. The CT appearances of other major thoracic injuries are described, including pulmonary lacerations, pneumothoraces, malpositioned chest tubes, mediastinal hematomas, aortic injury, tracheobronchial injury, hemopericardium, and spinal injuries with paraspinal fluid collections. Children demonstrating findings incidental to the actual injury yet important to the subsequent therapy are also presented. We conclude that, in the event of clinically significant blunt chest trauma, the single supine chest examination in the trauma room is insufficient to adequately identify the extent of intrathoracic injury. With the exception of concern for aortic injury for which aortography is indicated, a dynamically enhanced CT scan of the thorax should be performed as clinically significant findings may result in altered therapy. (orig.)

Prevalence and impact of diffuse axonal injury in patients with moderate and severe head injury: a cohort study of early magnetic resonance imaging findings and 1-year outcome.

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