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Sample records for contusions

  1. Quadriceps Contusion

    Science.gov (United States)

    ... are: An intramuscular contusion , which is when a muscle tears within the sheath (lining) that surrounds it. An ... it might be needed if there's a complete muscle tear or if a quadriceps contusion doesn't heal ...

  2. Spinal Cord Contusion

    Institute of Scientific and Technical Information of China (English)

    Gong Ju; Jian Wang; Yazhou Wang; Xianghui Zhao

    2014-01-01

    Spinal cord injury is a major cause of disability with devastating neurological outcomes and lim-ited therapeutic opportunities, even though there are thousands of publications on spinal cord injury annually. There are two major types of spinal cord injury, transaction of the spinal cord and spinal cord contusion. Both can theoretically be treated, but there is no well documented treatment in human being. As for spinal cord contusion, we have developed an operation with fabulous result.

  3. Desferrioxamine reduces oxidative stress in the lung contusion.

    Science.gov (United States)

    Basaran, Umit Nusret; Ayvaz, Suleyman; Aksu, Burhan; Karaca, Turan; Cemek, Mustafa; Karaboga, Ihsan; Inan, Mustafa; Aksu, Feyza; Pul, Mehmet

    2013-01-01

    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.

  4. Desferrioxamine Reduces Oxidative Stress in the Lung Contusion

    Directory of Open Access Journals (Sweden)

    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.

  5. Desferrioxamine Reduces Oxidative Stress in the Lung Contusion

    OpenAIRE

    2013-01-01

    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+DF...

  6. Pulmonary contusion in the pediatric population.

    Science.gov (United States)

    Hamrick, Miller Carlton; Duhn, Ryan Donsworth; Carney, David Edward; Boswell, William Carson; Ochsner, Mims Gage

    2010-07-01

    Pulmonary contusion in the adult population is an independent risk factor for respiratory failure, ventilator associated pneumonia, and acute respiratory distress syndrome. Pilot studies in adults note an increased risk when volume of pulmonary contusion exceeds 20 per cent of total lung volume. The purpose of this study was to determine if children with pulmonary contusion suffer the same morbidity as adults. From January 2005 to May 2007, all trauma patients ages 3 to 18-years-old were assessed for CT evidence of pulmonary contusion. Children were excluded if injury included confounding variables, which could result in respiratory failure independent of contusion status. CT images were reviewed and pulmonary contusion was calculated as a percentage of total lung volume. Outcomes including need for invasive ventilation, pneumonia, and development of oxygenation problems were recorded. Data collected included patient age, Injury Severity Score, arterial blood gas findings, and number of rib fractures. Twenty-six patients met criteria for the study with a mean age of 13.35 years and mean Injury Severity Score of 24. The mean percentage of pulmonary contusion was 19.81 per cent. No patients required intubation. Pediatric pulmonary contusion does not carry the same morbidity as noted in the adult population. Invasive airway management is rarely required.

  7. Bedside ultrasound diagnosis of pulmonary contusion.

    Science.gov (United States)

    Stone, Michael B; Secko, Michael A

    2009-12-01

    A 10-year-old boy presented to the emergency department after being struck by a van while crossing the street. He complained of right side chest pain, and a chest radiography was suggestive of pulmonary contusion. The treating physician performed a bedside ultrasound that revealed a right-sided pulmonary contusion that was subsequently confirmed on computed tomography of the thorax. The sonographic features of pulmonary contusion are described, and the possible role of lung sonography in the assessment of pediatric thoracic trauma is discussed.

  8. Diagnosing Myocardial Contusion after Blunt Chest Trauma

    Directory of Open Access Journals (Sweden)

    Zahra Alborzi

    2016-10-01

    Full Text Available A myocardial contusion refers to a bruise of the cardiac muscle, the severity of which can vary depending on the severity of the injury and when the injury occurs. It is a major cause of rapid death which happens after blunt chest trauma and should be suspected at triage in the emergency department. We demonstrated that suspected myocardial contusion patients who have normal electrocardiograms (ECGs and biomarker tests can be safely discharged. However, if the test results are abnormal, the next steps should be echocardiography and more advanced measures. Diagnosing myocardial contusion is very difficult because of its nonspecific symptoms. If a myocardial contusion happens, cardiogenic shock or arrhythmia must be anticipated, and the patient must be carefully monitored.

  9. Pulmonary contusion and hemothorax due to explosion

    National Research Council Canada - National Science Library

    Baeza-Herrera, Carlos; Sanjuán-Fabián, Héctor; Medellín-Sierra, Ulises Darío; Nájera-Garduño, Heladio; García-Cabello, Luis Manuel

    2006-01-01

    .... Such is the case of gunpowder explosive objects used during celebration holidays. We present a 14-year-old male who suffered a pulmonary contusion as a consequence of an explosion of "huevo de codorniz...

  10. Lung contusion from focal low-moderate chest trauma.

    Science.gov (United States)

    Hafen, G M; Massie, J

    2006-10-01

    Apparently minor chest trauma may result in localized pulmonary contusion. Complications of the contusion, particularly infection, may be delayed. The association between the infection and initial injury may not be appreciated due to the time frame between the injury and clinical presentation. We report two cases of low-moderate impact pulmonary trauma resulting in focal pulmonary contusion, complicated by infection.

  11. Bone contusion progression from traumatic knee injury: association of rate of contusion resolution with injury severity

    Science.gov (United States)

    Pedersen, Douglas R; El-Khoury, Georges Y; Thedens, Dan R; Saad-Eldine, Mothana; Phisitkul, Phinit; Amendola, Annunziato

    2017-01-01

    Background Bone contusions are frequently encountered in magnetic resonance imaging (MRI) evaluation of knee anterior cruciate ligament (ACL) injuries. Their role as indicators of injury severity remains unclear, primarily due to indeterminate levels of joint injury forces and to a lack of preinjury imaging. Purpose The purpose of this study was to 1) quantify bone contusion pathogenesis following traumatic joint injuries using fixed imaging follow-ups, and 2) assess the feasibility of using longitudinal bone contusion volumes as an indicator of knee injury severity. Study design Prospective sequential MRI follow-ups of a goat cohort exposed to controlled stifle trauma in vivo were compared to parallel clinical MRI follow-ups of a human ACL tear patient series. Methods Reproducible cartilage impact damage of various energy magnitudes was applied in a survival goat model, coupled with partial resection of anterior portions of medial menisci. Both emulate injury patterns to the knee osteochondral structures commonly encountered in human ACL injury imaging as well as instability from resultant ligament laxity. Longitudinal clinical MRI sequences portrayed stifle bone contusion evolution through 6 months after the inciting event. Results In the first 2 weeks, biological response variability dominated the whole-joint response with no apparent correlation to trauma severity. Control goats subjected to partial meniscectomy alone exhibited minimal bone response. Thereafter, 0.6 J impact bone contusions portrayed a faster rate of resolution than those induced by 1.2 J cartilage impacts. Conclusion Bone contusion sizes combined with time of persistence are likely better measures of joint injury severity than isolated bone contusion volume.

  12. Acupuncture Treatment for Optic Nerve Contusion

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Optic nerve contusion is a commonly-seen eye injury, which is mostly caused by traffic accident, collision, and falling. Early diagnosis and timely emergency treatment can make such patients restore vision to a certain extent. Otherwise, there may appear optic atrophy or loss of vision. At present, in the treatment of this disease, cortical hormone, dehydrating agent, vasodilator, vitamin, energy mixture and neurotrophic agent, or surgical operation can all give certain therapeutic effect. In the recent 5 years, the Department of Ophthalmology of the Hospital Affiliated to Hubei College of Traditional Chinese Medicine has adopted acupuncture for treatment of optic nerve contusion, and obtained quite good therapeutic results. Some typical cases are reported in the following.

  13. RESPIRATORY REEDUCATION IN THORACIC CONTUSION RECOVERY

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    Aurelia PREDA

    2015-04-01

    Full Text Available Respiratory reeducation is a way to recover the thoracic contusion. Correcting dyspnea induced by pain, decreases the required postcontuzional recovery time and, therefore, the required social reintegration time. This is achieved an increasing of the pacient life quality, and significant savings of human and material resources: reducing medical and somato-functional recovery costs, reducing the sick leave payment and the work days off to. The „TES” device has been designed in order to improve respiratory reeducation and to recover the thoracic contusion. A study showed that the postcontuzional recovery was significantly increased by using the physical exercises of respiratory reeducation. The „TES” device demonstrated his role in this.

  14. [Pulmonary contusion and hemothorax due to explosion].

    Science.gov (United States)

    Baeza-Herrera, Carlos; Sanjuán-Fabián, Héctor; Medellín-Sierra, Ulises Darío; Nájera-Garduño, Heladio; García-Cabello, Luis Manuel

    2006-01-01

    Folklore and "uses and customs" in countries such as Mexico, under certain circumstances, have direct influences on risks for traumatic injuries. Such is the case of gunpowder explosive objects used during celebration holidays. We present a 14-year-old male who suffered a pulmonary contusion as a consequence of an explosion of "huevo de codorniz." A pleurostomy tube was required to resolve symptomatic hemothorax. The patient was discharged 5 days after admission.

  15. Mechanism of neutrophil recruitment to the lung after pulmonary contusion

    OpenAIRE

    2011-01-01

    Blunt chest trauma resulting in pulmonary contusion is a common but poorly understood injury. We previously demonstrated that lung contusion activates localized and systemic innate immune mechanisms and recruits neutrophils to the injured lung. We hypothesized that the innate immune and inflammatory activation of neutrophils may figure prominently in the response to lung injury. To investigate this, we used a model of pulmonary contusion in the mouse that is similar to that observed clinicall...

  16. Histo-morphology of age of contusions: An autopsy study

    Directory of Open Access Journals (Sweden)

    A K Unmesh

    2012-06-01

    Full Text Available Background : During forensic evaluation the determination of age of contusions play a very important role. Age of contusions is normally determined based on their colour. Different authors have different interpretations of age of contusions based on colour. Objective : The aim of the present study is to have a first hand information regarding the colour changes occurring in contusions with the passage of time, in our population and also to compare the aging process of contusions in our population with the standard data available Methods: Contusions were classified into small, medium and large. Both naked eye examination of colour of contusions and microscopic examination of contusions were done. Perl’s staining was also done to confirm the presence of pigments. Results: 65 male and 15 female patients were included in the study. Majority of the cases the contusions were due to road traffic accidents. It was observed that in contusions of 24 hrs duration it was red in colour,followed by blue colour for two to three days. Contusions of four to six days were bluish black coloured and green in colour by seventh day. Microscopic examination revealed the presence of RBC in injuries less than 24 hrs duration. Lymphocytes and polymorphs were prominent in third and fourth day of injury. Perl’s stain was positive from the fifth day onwards. Conclusion : The observations of colour tone of injury and histopathological findings including special staining techniques like Perl’s stain can help the forensic pathologist to a certain extent in dating the age of medium sized contusion in moderately nourished adult subjects during the initial phases of injury. [National J of Med Res 2012; 2(3.000: 339-342

  17. Paraplegia caused by cerebral contusions in the bilateral precentral gyri

    Directory of Open Access Journals (Sweden)

    Hideaki Matsumura

    2016-01-01

    Conclusion: We must emphasize that cerebral contusion can be a differential diagnosis for paraplegia. In the acute phase, fluid-attenuated inversion recovery (FLAIR MRI coronal and sagittal images are useful for identifying precentral gyri contusions. Paraplegia caused by a cerebral contusion may be misdiagnosed as a spinal concussion due to the disappearance of the precentral gyrus lesion on FLAIR MRI in the subacute phase.

  18. Club cell protein 16 as a biomarker in pulmonary contusion

    OpenAIRE

    Wu, Feng; Ding, Boying; Yang, Xiaolong; Ma, Dongchun; Zhang, Chaodong; Hua, Congshu

    2016-01-01

    The aim of the present study was to investigate the variation and clinical significance of the 16-kDa club cell protein (CC16) in patients with pulmonary contusion. A total of 42 patients with pulmonary contusion were divided into experimental groups I (n=24, moderate pulmonary contusion) and II (n=18, severe pulmonary contusion). An enzyme-linked immunosorbent assay was used to detect the serum levels of CC16 in the two groups of patients within 24 h after the incident and at days 1, 3, 7 an...

  19. [Contusive ocular trauma--case report].

    Science.gov (United States)

    Muşat, O; Coman, Corina; Cristescu, R; Asandi, R

    2012-01-01

    We present the case of a 48 year old man who was admitted for the decreased visual acuity of the left eye for about 20 years, when a left sided facial trauma had occured. Clinical examination and lab exams revealed the cause of this change: ocular contusive posttraumatic status for about 20 years (anamnestic), iridodialysis, corectopie, traumatic cataract, PVR, tractional retinal detachment. Surgical treatment was warranted. We performed cataract extraction, posterior vitrectomy with laser fotocoagulation and injection of silicon oil 1000. We followed the pacient's post-operative evolution and we extracted of the silicone oil six months later. The evolution was favorable.

  20. Pulmonary contusion in a collegiate diver: a case report

    Directory of Open Access Journals (Sweden)

    Lively Mathew W

    2011-08-01

    Full Text Available Abstract Introduction Pulmonary contusions typically occur after high-energy trauma and have rarely been reported as occurring during participation in sports. This is the first reported case of a pulmonary contusion occurring in a sport other than football. Case Presentation A 19-year-old Caucasian man impacted the water awkwardly after diving off a one-meter springboard. He complained of chest discomfort and produced immediate hemoptysis. Computed tomography confirmed the diagnosis of pulmonary contusion. The athlete recovered without complications and returned to activity one week after injury. Conclusion Immediate hemoptysis following blunt chest trauma during sports activity may indicate an underlying pulmonary contusion. No specific guidelines exist for return to athletic competition following pulmonary contusion, but a progressive return to activities once symptoms resolve appears to be a reasonable approach.

  1. A modified rat model of isolated bilateral pulmonary contusion.

    Science.gov (United States)

    Wang, Shaohua; Ruan, Zheng; Zhang, Jie; Zheng, Jin

    2012-09-01

    The aim of the present study was to create a feasible specific rat model of isolated bilateral pulmonary contusion (PC) and to evaluate the relationship between severity of hypoxemia and quantity of contusion lesions. Anesthetized rats were placed in a prone position. Injury energy ranging from 2.1 to 3.0 J was produced by a falling weight passed through a specially designed arched shield to the bilateral chest wall of rats. After injury (4 h), the contusion volume was measured using computer-generated three-dimensional reconstruction from a chest computed tomographic scan and expressed as a percentage of total lung volume. Arterial partial pressure of oxygen (PaO(2)) in blood gas analysis and contusion volume percentage were used to assess the severity of contusion. Heart and lung biopsy was used to confirm the diagnosis and rule out the existence of myocardial contusion. There were 3 cases of death and 1 case of death in the 3.0 J and the 2.4 J group, respectively. PaO(2) in the 2.7 J group was significantly lower than that in the lower energy groups (Ppulmonary contusion in the 2.7 J group was significantly higher compared to that of the lower energy groups (Pcontusion percentage (R(2)=0.76). Hemorrhage, edema and neutrophil infiltration were determined by lung biopsy. No evidence of myocardial contusion was documented in multiple heart biopsies. The method illustrated in this research effectively duplicates isolated bilateral pulmonary contusion in rats, the severity of which is highly correlated with the contusion size. Thus, 2.7 J can be regarded as the maximal energy for sublethal injury.

  2. Outcome in patients with blunt chest trauma and pulmonary contusions

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    Vignesh T

    2004-01-01

    Full Text Available ABSTRACT: Severe pulmonary contusions occur in blunt chest trauma, especially with high velocity injuries. Pulmonary contusions following trauma may result in significant hypoxemia and decreased compliance which may progress over several days. Extensive contusions may result in respiratory difficulty or progress to adult respiratory distress syndrome, which increases mortality. We decided to review the cases of polytrauma with associated pulmonary contusions to determine the factors which influence outcome. MATERIALS AND METHODS: A retrospective chart review of all cases of trauma with pulmonary contusions on X-ray or CT scan. The cases were examined for age, type of injuries, admission APACHE II, SAPS II and SOFA scores, PaO2/FiO2 ratio, presence or absence of rib fractures, average positive fluid balance, average sedation dose, pulmonary haemorrhage, ventilator days, ICU days and hospital outcome. RESULTS: There were 18 cases of pulmonary contusions. All had associated injuries. 6 patients died, 4 in the ICU and 2 patients died 1 week after transfer to a high dependency unit, one due to sepsis and the other due to massive haemothorax. There was a significant difference in PaO2/FiO2 ratio at admission and throughout the ICU course, fluid balance and sedation dose, but not in ventilator days and ICU days between survivors and nonsurvivors. The incidence, frequency and amount of pulmonary haemorrhage were higher in the nonsurvivors. CONCLUSIONS: Close attention to improving gas exchange, and early management of hemoptysis might improve outcome in pulmonary contusions

  3. Evaluating of Serum Adenosine Deaminase Isoenzymes in Lung Contusion

    OpenAIRE

    2013-01-01

          Aim: We aimed to investigate the activity of ADA isoenzymes in serum of rats with lung contusion Material and Method: Lung contusion was induced in twelve male wistar albino rats by dropping a cylindrical weight from a height of 50 cm with a mobile platform positioned over the thorax. Rats were killed at 24 hour (n=6) and 72 hour (n=6) after contusion. ADA isoenzymes were measured in serum traumatic and control (n=6) (uninjured) rats. Results: Our results indica...

  4. A modified rat model of isolated bilateral pulmonary contusion

    OpenAIRE

    Wang, Shaohua; Ruan, Zheng; Jie ZHANG; ZHENG, JIN

    2012-01-01

    The aim of the present study was to create a feasible specific rat model of isolated bilateral pulmonary contusion (PC) and to evaluate the relationship between severity of hypoxemia and quantity of contusion lesions. Anesthetized rats were placed in a prone position. Injury energy ranging from 2.1 to 3.0 J was produced by a falling weight passed through a specially designed arched shield to the bilateral chest wall of rats. After injury (4 h), the contusion volume was measured using computer...

  5. Pulmonary contusion: an update on recent advances in clinical management.

    Science.gov (United States)

    Cohn, Stephen M; Dubose, Joseph J

    2010-08-01

    Pulmonary contusion is a common finding after blunt chest trauma. The physiologic consequences of alveolar hemorrhage and pulmonary parenchymal destruction typically manifest themselves within hours of injury and usually resolve within approximately 7 days. Clinical symptoms, including respiratory distress with hypoxemia and hypercarbia, peak at about 72 h after injury. The timely diagnosis of pulmonary contusion requires a high degree of clinical suspicion when a patient presents with trauma caused by an appropriate mechanism of injury. The clinical diagnosis of acute parenchymal lung injury is usually confirmed by thoracic computed tomography, which is both highly sensitive in identifying pulmonary contusion and highly predictive of the need for subsequent mechanical ventilation. Management of pulmonary contusion is primarily supportive. Associated complications such as pneumonia, acute respiratory distress syndrome, and long-term pulmonary disability, however, are frequent sequelae of these injuries.

  6. Multiple pulmonary contusions in a collegiate football player

    Directory of Open Access Journals (Sweden)

    Michael Phy

    2014-10-01

    Full Text Available Pulmonary contusion is an infrequently reported event in contact sports. To date, there are only four reported cases in football players in the literature. This case is unique in its presentation (large contusion, coup/contrecoup injuries and management (need for air transport shortly after the injury, persistent symptoms, delayed recovery and return to play. Clinical signs and symptoms, such as dyspnea, hemoptysis, and chest wall pain, should increase the suspicion for possible pulmonary contusion. Early imaging with computed tomography (CT is preferred due to its superior sensitivity and specificity (compared to chest radiography in detecting pulmonary contusions. In addition, CT scans can quantify the amount of lung damage which can be used in treatment decisions and prognosis. Treatment requires close monitoring and management off requently associated pulmonary symptoms, such as chest wall pain and hypoxia.

  7. Linear scleroderma after contusion and injection of mepivacaine hydrochloride.

    Science.gov (United States)

    Ueda, Takashi; Niiyama, Shiro; Amoh, Yasuyuki; Katsuoka, Kensei

    2010-05-15

    A 36-year-old woman initially was treated for a contusion by local injection of mepivacaine hydrochloride into the left dorsum of the foot. Approximately 3 months after the injury and injection, linear sclerotic plaques originating from the site of contusion and injection were recognized. These progressed in extent and severity over a period of 3 years, when she presented to our clinic. By biopsy, swelling of collagen fibers in the lower dermis was revealed and the condition was diagnosed as linear scleroderma. Our present case had multiple linear sclerotic plaques of the left lower extremity, the distribution of which was consistent with Blaschko lines. It was also revealed that the initial sclerotic plaque was at the site of the contusion and local mepivacaine hydrochloride injection. Our present case is interesting in that the findings suggest a correlation between linear scleroderma plaque occurrence and the contusion or injection of mepivacaine.

  8. Pulmonary contusion in a collegiate diver: a case report

    OpenAIRE

    2011-01-01

    Abstract Introduction Pulmonary contusions typically occur after high-energy trauma and have rarely been reported as occurring during participation in sports. This is the first reported case of a pulmonary contusion occurring in a sport other than football. Case Presentation A 19-year-old Caucasian man impacted the water awkwardly after diving off a one-meter springboard. He complained of chest discomfort and produced immediate hemoptysis. Computed tomography confirmed the diagnosis of pulmon...

  9. Evaluating of Serum Adenosine Deaminase Isoenzymes in Lung Contusion

    Directory of Open Access Journals (Sweden)

    Berrak Güven

    2013-05-01

    Full Text Available       Aim: We aimed to investigate the activity of ADA isoenzymes in serum of rats with lung contusion Material and Method: Lung contusion was induced in twelve male wistar albino rats by dropping a cylindrical weight from a height of 50 cm with a mobile platform positioned over the thorax. Rats were killed at 24 hour (n=6 and 72 hour (n=6 after contusion. ADA isoenzymes were measured in serum traumatic and control (n=6 (uninjured rats. Results: Our results indicated that serum total ADA activities were significantly decreased at 72 h after contusion. There was a significant decreased in ADA1 activity at 24 and 72 h after contusion when compared with controls. On the other hand, the increase in the ADA2 activity at 24 h and 72 h was not statistically significant. Discussion: In conclusion, serum ADA2 became predominant isozyme because of the inflammatory response in the lung contusion. However, further studies are needed to elucidate the regulatory mechanisms that effect the activity of serum ADA1.

  10. Mechanism of neutrophil recruitment to the lung after pulmonary contusion.

    Science.gov (United States)

    Hoth, J Jason; Wells, Jonathan D; Hiltbold, Elizabeth M; McCall, Charles E; Yoza, Barbara K

    2011-06-01

    Blunt chest trauma resulting in pulmonary contusion is a common but poorly understood injury. We previously demonstrated that lung contusion activates localized and systemic innate immune mechanisms and recruits neutrophils to the injured lung. We hypothesized that the innate immune and inflammatory activation of neutrophils may figure prominently in the response to lung injury. To investigate this, we used a model of pulmonary contusion in the mouse that is similar to that observed clinically in humans and evaluated postinjury lung function and pulmonary neutrophil recruitment. Comparisons were made between injured mice with and without neutrophil depletion. We further examined the role of chemokines and adhesion receptors in neutrophil recruitment to the injured lung. We found that lung injury and resultant physiological dysfunction after contusion were dependent on the presence of neutrophils in the alveolar space. We show that CXCL1, CXCL2/3, and CXCR2 are involved in neutrophil recruitment to the lung after injury and that intercellular adhesion molecule 1 is locally expressed and actively participates in this process. Injured gp91-deficient mice showed improved lung function, indicating that oxidant production by neutrophil NADPH oxidase mediates lung dysfunction after contusion. These data suggest that both neutrophil presence and function are required for lung injury after lung contusion.

  11. Effect of ghrelin on inflammatory response in lung contusion.

    Science.gov (United States)

    Guven, Berrak; Gokce, Mertol; Saydam, Ozkan; Can, Murat; Bektas, Sibel; Yurtlu, Serhan

    2013-02-01

    The purpose of this study was to investigate the effects of ghrelin on inflammatory response and tissue damage following trauma-induced acute lung injury. Thirty male wistar albino rats (300-400 g) were randomly assigned into three groups: control group (n = 6), lung contusion plus saline (saline-treated, n = 12), and lung contusion plus ghrelin (ghrelin-treated, n = 12). Saline- or ghrelin-treated traumatic rats were sacrificed at two time points (24 and 72 hours) after lung contusion. Blood was collected for the analysis of serum adenosine deaminase (ADA). Tissue transforming growth factor-beta 1 (TGF-β1) and matrix metalloproteinase-2 (MMP-2) levels were measured by enzyme-linked immunosorbent assay and histopathological examination was performed on the lung tissue samples. Our results indicated that ghrelin significantly reduced morphologic damages. Serum ADA activities were significantly decreased after lung contusion and this decline started early with ghrelin treatment. TGF-β1 and MMP-2 levels in lung tissue were elevated at 72 hours after lung contusion and treatment with ghrelin significantly increased TGF-β1 level and reduced MMP-2 level. In conclusion, our study demonstrates that acute lung injury initiated proinflammatory responses and ghrelin administration showed an anti-inflammatory effect in lung contusion.

  12. Most severe consequences of eye contusion injuries: Surgical treatment

    Directory of Open Access Journals (Sweden)

    Vukosavljević Miroslav

    2006-01-01

    Full Text Available Introduction. One third of all eye injuries are contusion injuries. The most common causes of contusion eye injuries are squash ball, fist fights, sports, and work with blunt objects. Objective. The objective of our study was to analyze the surgical treatment methods and materials for managing the most severe consequences of eye contusion injuries. Method. A large number of complications of contusion eye injuries were treated at Department for Vitreoretinal Surgery of the Eye Clinic, Military Medical Academy, Belgrade. This paper analyzed two periods, from 1991-1999, and 2000-2004. During these periods, 461 patients with contusion eye injuries were surgically treated. Pars plana vitrectomy and phacoemulsification with PCL implantation were the most commonly performed operations. Results. During the analyzed period, a total of 334 pars plana vitrectomies, 253 combined operations (PHACO+ VPP and 214 operations with PCL implantation (PHACO+VPP+PCL were performed. Scleral fixation was carried out in 14 patients. After pars plana vitrectomy, some form of extended tamponade of vitreal space, in relation to degree of injury and complications, was performed in 194 cases. CONCLUSION Eye traumatism is still one of the leading causes of vision loss (from the earliest ages in our region. Preventive measures that could lead to decrease of eye injuries should be fully supported, not only through expert meetings and publications, but via media as well.

  13. Predictors of pneumonia in trauma patients with pulmonary contusion.

    Science.gov (United States)

    Janus, Todd J; Vaughan-Sarrazin, Mary S; Baker, Larry J; Smith, Hayden L

    2012-01-01

    The purpose of this article was to determine assessable risk levels for pneumonia in trauma patients with pulmonary contusion. A retrospective review and analysis of national trauma data of patients with pulmonary contusion were identified to develop a risk assessment model. Trauma data for 2007 were used to determine risk factors for subsequent complication of pneumonia in pulmonary contusion patients. Available patient comorbidities were considered in model development. Next, 2008 data were used to test and finalize model. Pneumonia risk was categorized into 3 ordinal levels, based on equal-sized proportions of pulmonary contusion patients. Significant risk factors for pneumonia included age, gender, pulse rate, systolic blood pressure, obesity, Glasgow Coma Scale motor score, and ventilation on admission. The final risk adjustment model had good fit and discrimination. Study analyses used more than 40 000 trauma patient data to devise assessable risk levels for pneumonia in pulmonary contusion diagnosed patients. Study data can assist in direction of care and triaging of urgent care patients at risk of pneumonia, possibly leading to mitigation and prevention of pneumonia in at risk patients. Further review of study outcomes should occur to fully understand applicability and usefulness in urgent settings.

  14. Intracranial pressure monitoring for special patterns of frontal lobe contusions

    Institute of Scientific and Technical Information of China (English)

    DONG Ji-rong; CAI Xue-jian; WANG Biao; WANG Yu-hai; SHI Zhong-hua; LIU Bing; CAI Sang; XU Qin-yi

    2010-01-01

    Objective:To study the effect and indications of intracranial pressure(ICP)monitoring for frontal lobe contusion patients.Methods:During January 2005-December 2008,34 cases of frontal lobe contusion received ICP monitoring in our department(monitoring group).Different treatment protocols were adopted according to the results of ICP.Meanwhile 46 cases of same type of head-injured patients who did not undergo ICP monitoring served as control group.Results:We found that ICP elevated dramatically within 24 hours after head injury if the contusions were located in frontal longitudinal dehiscence,bilateral undersurface of frontal lobe or dispersed in bilateral lobe.After half a year follow-up and on the basis of Glasgow Coma Scale assessment,the monitoring group showed better outcome than the control group with good recovery in 24 cases(70.6%),moderate disability in 7 cases(20.6%),severe disability in 2(5.88%)and death in 1(2.94%).The outcome of control group displayed good condition in 25 cases(54.3%),moderate disabilities in 8(17.4%),severe disability in 7(15.2%),and death in 6(13.0%).Conclusions:Frontal lobe contusions are vulnerable and complex head injuries,especially when the contusions are located in frontal longitudinal dehiscence,bilateral undersurface of frontal lobe or diffused in bilateral lobes.These patients should undergo ICP monitoring regardless of their consciousness status.If ICP elevates over 25 mm Hg,the craniotomy is mandatory and will markedly reduce the mortality and disability of these patients.

  15. Critical evaluation of pulmonary contusion in the early post-traumatic period: risk of assisted ventilation.

    Science.gov (United States)

    Hamrick, Miller C; Duhn, Ryan D; Ochsner, M Gage

    2009-11-01

    This study attempts to accurately quantify pulmonary contusion and predict those patients most likely to require assisted ventilation early in their hospital course. Patients admitted to a Level I trauma center were evaluated for pulmonary contusion by helical CT scan. Scans were reviewed by a single radiologist who attempted to accurately quantify contusion as a percentage of total lung volume. These patients were then followed for 48 hours in an attempt to use CT measurements of contusion to predict those that would require assisted ventilation early in their hospital course. After using numerous exclusion criteria, 152 patients were included in the study. Of these, 31 patients (20%) required assisted ventilation within 48 hours of hospital admission. Twenty per cent pulmonary contusion proved to be a highly predictive variable leading to need for assisted ventilation. Of patients sustaining contusion, only 7 of 92 (8%) required assisted ventilation versus 24 of 60 (40%) sustaining >20 per cent contusion. Pulmonary contusion is a significant injury especially when contusion volume exceeds 20 per cent of total lung volume. With accurate measurement of contusion, we can identify those patients at high risk of requiring assisted ventilation early in their hospital course.

  16. The creation of a measurable contusion injury in skeletal muscle

    Directory of Open Access Journals (Sweden)

    Margaret N. Deane

    2014-02-01

    Full Text Available The effect that compressed air massage (CAM has on skeletal muscle has been ascertained by the morphological and morphometric evaluation of healthy vervet monkey and rabbit skeletal muscle. How CAM may influence the process of healing following a contusion injury is not known. To determine how CAM or other physiotherapeutic modalities may influence healing, it is necessary to create a minor injury that is both reproducible and quantifiable at the termination of a pre-determined healing period. An earlier study described changes in the morphology of skeletal muscle following a reproducible contusion injury. This study extended that work in that it attempted to quantify the ‘severity’ of such an injury. A 201 g, elongated oval-shaped weight was dropped seven times through a 1 m tube onto the left vastus lateralis muscle of four New Zealand white rabbits. Biopsies were obtained 6 days after injury from the left healing juxta-bone and sub-dermal muscle and uninjured (control right vastus lateralis of each animal. The tissue was fixed in formal saline, embedded in wax, cut and stained with haematoxylin and phosphotungstic haematoxylin. The muscle was examined by light microscopy and quantification of the severity of injury made using a modified, ‘in-house’ morphological index and by the comparative morphometric measurement of the cross-sectioned epimysium and myofibres in injured and control muscle. The results showed that a single contusion causes multiple, quantifiable degrees of injury from skin to bone – observations of particular importance to others wishing to investigate contusion injury in human or animal models.

  17. Pulmonary contusion and acute respiratory distress syndrome (ARDS) as complications of blunt chest trauma

    National Research Council Canada - National Science Library

    Michalska, Agata; Jurczyk, Agnieszka P; Machała, Waldemar; Szram, Stefan; Berent, Jarosław

    2009-01-01

    .... The authors of the article would like to emphasize the pathophysiology and diagnostic difficulties in such blunt chest trauma complications as pulmonary contusions and acute respiratory distress...

  18. Diaphragm and intercostal muscle activity following mid-cervical spinal cord contusion in the rat.

    Science.gov (United States)

    Wen, Ming-Han; Lee, Kun-Ze

    2017-08-26

    The present study was designed to investigate the diaphragm and intercostal muscle activity following unilateral mid-cervical spinal cord contusion in rats. Electromyogram (EMG) activity of the bilateral diaphragm and T2 intercostal muscle was measured in anesthetized and spontaneously breathing rats. Unilateral mid-cervical contusion caused an immediate reduction in inspiratory bursting in the bilateral diaphragm and intercostal muscles. From 3 days to 8 weeks post-contusion, the contused animals displayed significantly lower tidal volume than uninjured animals, regardless of the time point after injury. The burst amplitude of the contralateral diaphragm EMG was augmented in contused animals at 3 days post-injury. When the data were normalized by the maximal response during hypoxic-hypercapnic challenge (12-13 % O2, 3-4 % CO2), the ipsilateral diaphragm EMG of contused animals was greater than that of uninjured animals at 3 days and 2 weeks post-injury. Moreover, hypoxia-hypercapnia induced increases in ipsilateral diaphragm EMG activity were blunted in contused animals at 2 weeks post-injury but recovered at 8 weeks post-injury. Bilateral diaphragm EMG activity in contused animals was comparable to uninjured animals at 8 weeks post-injury. Notably, intercostal muscle activity was not substantially changed by mid-cervical spinal cord contusion from 3 days to 8 weeks post-contusion. These results suggest that mid-cervical spinal contusion induces a compensatory increase in contralateral diaphragmatic activity and greater utilization of a percentage of maximal inspiratory activity in the ipsilateral diaphragm. The maintenance of intercostal muscle activity may enable the animal to sustain essential breathing capacity following cervical spinal cord injury.

  19. Examination of pneumonia risks and risk levels in trauma patients with pulmonary contusion.

    Science.gov (United States)

    Landeen, Carolina; Smith, Hayden L

    2014-01-01

    Development of pneumonia in patients with pulmonary contusion can result in morbidity and mortality. This study examined the utility of a pneumonia risk tool for pulmonary contusion patients, which was originally developed using national level data. The study found a 21% prevalence of pneumonia diagnosis in pulmonary contusion patients at the examined level I trauma center, with patients in the high-risk group having 8 times greater odds for pneumonia diagnosis. The study also revealed increasing age and the use of mechanical ventilation as being significantly associated with pneumonia status. Early identification of risk factors for pneumonia could help direct clinician care strategies.

  20. Lung contusion: inflammatory mechanisms and interaction with other injuries.

    Science.gov (United States)

    Raghavendran, Krishnan; Notter, Robert H; Davidson, Bruce A; Helinski, Jadwiga D; Kunkel, Steven L; Knight, Paul R

    2009-08-01

    This article reviews current animal models and laboratory studies investigating the pathophysiology of lung contusion (LC), a common and severe condition in patients with blunt thoracic trauma. Emphasis is on studies elucidating cells, mediators, receptors, and processes important in the innate pulmonary inflammatory response that contribute to LC injury. Surfactant dysfunction in the pathogenesis of LC is also discussed, as is the potential role of epithelial cell or neutrophil apoptosis. Studies examining combination injuries where LC is exacerbated by secondary insults such as gastric aspiration in trauma patients are also noted. The need for continuing mechanism-based research to further clarify the pathophysiology of LC injury, and to define and test potential therapeutic interventions targeting specific aspects of inflammation or surfactant dysfunction to improve clinical outcomes in patients with LC, is also emphasized.

  1. [Severe pulmonary contusion after extracorporeal shock wave lithotripsy].

    Science.gov (United States)

    Samkaoui, M A; Ziadi, A; Harifi, G; El Adib, A Rhassan; Younous, S

    2009-03-01

    Extracorporeal shock wave lithotripsy (ESWL) is a simple and effective treatment of urinary stones. Renowned less aggressive than surgery, it knew a wide success and constitutes therefore the treatment of first intention of the majority of the kidney stones. Nevertheless, traumatic renal and extrarenal complications notably in lung can arise after ESWL. We report the case of a 28-year-old patient who had a pulmonary contusion following a lithotripsy for a left kidney stone and whose evolution was favourable after two weeks in intensive care unit. Through this observation and the analysis of the rare reported cases in the literature, we insist on the different varieties of pulmonary complications of the ESWL, the hypothesis explaining the mechanisms of their arising as well as the precautions to take to avoid them.

  2. Alveolar recruitment in pulmonary contusion: case report and literature review

    OpenAIRE

    Lívia Maria Vitório Trindade; Lucianne Cristina da Silva Lopes; Graziella França Bernardelli Cipriano; Letícia Sandre Vendrame; Ary Andrade Junior

    2009-01-01

    O tratamento da contusão pulmonar quando instituído de forma correta é bastante simples na maioria das vezes. As alterações fisiopatológicas acontecem como decorrência dos efeitos produzidos pela perda da integridade da parede torácica, acúmulo de líquidos na cavidade pleural, obstrução da via aérea e disfunção pulmonar. A manobra de recrutamento alveolar consiste na reabertura de áreas pulmonares colapsadas através do aumento da pressão inspiratória na via aérea. O objetivo deste relato foi ...

  3. Ventilation-perfusion relationships following experimental pulmonary contusion.

    Science.gov (United States)

    Batchinsky, Andriy I; Weiss, William B; Jordan, Bryan S; Dick, Edward J; Cancelada, David A; Cancio, Leopoldo C

    2007-09-01

    Ventilation-perfusion changes after right-sided pulmonary contusion (PC) in swine were investigated by means of the multiple inert gas elimination technique (MIGET). Anesthetized swine (injury, n = 8; control, n = 6) sustained a right-chest PC by a captive-bolt apparatus. This was followed by a 12-ml/kg hemorrhage, resuscitation, and reinfusion of shed blood. MIGET and thoracic computed tomography (CT) were performed before and 6 h after injury. Three-dimensional CT scan reconstruction enabled determination of the combined fractional volume of poorly aerated and non-aerated lung tissue (VOL), and the mean gray-scale density (MGSD). Six hours after PC in injured animals, Pa(O(2)) decreased from 234.9 +/- 5.1 to 113.9 +/- 13.0 mmHg. Shunt (Q(S)) increased (2.7 +/- 0.4 to 12.3 +/- 2.2%) at the expense of blood flow to normal ventilation/perfusion compartments (97.1 +/- 0.4 to 87.4 +/- 2.2%). Dead space ventilation (V(D)/V(T)) increased (58.7 +/- 1.7% to 67.2 +/- 1.2%). MGSD increased (-696.7 +/- 6.1 to -565.0 +/- 24.3 Hounsfield units), as did VOL (4.3 +/- 0.5 to 33.5 +/- 3.2%). Multivariate linear regression of MGSD, VOL, V(D)/V(T), and Q(S) vs. Pa(O(2)) retained VOL and Q(S) (r(2) = .835) as independent covariates of Pa(O(2)). An increase in Q(S) characterizes lung failure 6 h after pulmonary contusion; Q(S) and VOL correlate independently with Pa(O(2)).

  4. Neuroprotective Effects of Perflurocarbon (Oxycyte) after Contusive Spinal Cord Injury

    Science.gov (United States)

    Yacoub, Adly; Hajec, Marygrace C.; Stanger, Richard; Wan, Wen; Young, Harold

    2014-01-01

    Abstract Spinal cord injury (SCI) often results in irreversible and permanent neurological deficits and long-term disability. Vasospasm, hemorrhage, and loss of microvessels create an ischemic environment at the site of contusive or compressive SCI and initiate the secondary injury cascades leading to progressive tissue damage and severely decreased functional outcome. Although the initial mechanical destructive events cannot be reversed, secondary injury damage occurs over several hours to weeks, a time frame during which therapeutic intervention could be achieved. One essential component of secondary injury cascade is the reduction in spinal cord blood flow with resultant decrease in oxygen delivery. Our group has recently shown that administration of fluorocarbon (Oxycyte) significantly increased parenchymal tissue oxygen levels during the usual postinjury hypoxic phase, and fluorocarbon has been shown to be effective in stroke and head injury. In the current study, we assessed the beneficial effects of Oxycyte after a moderate-to-severe contusion SCI was simulated in adult Long-Evans hooded rats. Histopathology and immunohistochemical analysis showed that the administration of 5 mL/kg of Oxycyte perfluorocarbon (60% emulsion) after SCI dramatically reduced destruction of spinal cord anatomy and resulted in a marked decrease of lesion area, less cell death, and greater white matter sparing at 7 and 42 days postinjury. Terminal deoxynucleotidyl transferase dUTP nick end labeling staining showed a significant reduced number of apoptotic cells in Oxycyte-treated animals, compared to the saline group. Collectively, these results demonstrate the potential neuroprotective effect of Oxycyte treatment after SCI, and its beneficial effects may be, in part, a result of reducing apoptotic cell death and tissue sparing. Further studies to determine the most efficacious Oxycyte dose and its mechanisms of protection are warranted. PMID:24025081

  5. Lung Contusion: A Clinico-Pathological Entity with Unpredictable Clinical Course.

    Science.gov (United States)

    Ganie, Farooq Ahmad; Lone, Hafeezulla; Lone, Ghulam Nabi; Wani, Mohd Lateef; Singh, Shyam; Dar, Abdual Majeed; Wani, Nasir-U-Din; Wani, Shadab Nabi; Nazeer, Nadeem-Ul

    2013-01-01

    Lung contusion is an entity involving injury to the alveolar capillaries, without any tear or cut in the lung tissue. This results in accumulation of blood and other fluids within the lung tissue. The excess fluid interferes with gas exchange leading to hypoxia. The pathophysiology of lung contusion includes ventilation/perfusion mismatching, increased intrapulmonary shunting, increased lung water, segmental lung damage, and a loss of compliance. Clinically, patient's presents with hypoxiemia, hypercarbia and increase in laboured breathing. Patients are treated with supplemental oxygen and mechanical ventilation whenever indicated. Treatment is primarily supportive. Computed tomography (CT) is very sensitive for diagnosing pulmonary contusion. Pulmonary contusion occurs in 25-35% of all blunt chest traumas.

  6. Innate immune response to pulmonary contusion: Identification of cell-type specific inflammatory responses

    OpenAIRE

    Hoth, J. Jason; Wells, Jonathan D.; Yoza, Barbara K.; McCall, Charles E.

    2012-01-01

    Lung injury from pulmonary contusion is a common traumatic injury, predominantly seen after blunt chest trauma such as in vehicular accidents. The local and systemic inflammatory response to injury includes activation of innate immune receptors, elaboration of a variety inflammatory mediators, and recruitment of inflammatory cells to the injured lung. Using a mouse model of pulmonary contusion, we had previously shown that innate immune Toll like receptors 2 and 4 (TLR2 and TLR4) mediate the ...

  7. Lung Contusion: A Clinico-Pathological Entity with Unpredictable Clinical Course

    OpenAIRE

    Ganie, Farooq Ahmad; Lone, Hafeezulla; Lone, Ghulam Nabi; Wani, Mohd Lateef; Singh, Shyam; Dar, Abdual Majeed; Wani, Nasir-u-din; Wani, Shadab Nabi; Nazeer, Nadeem-ul

    2013-01-01

    Lung contusion is an entity involving injury to the alveolar capillaries, without any tear or cut in the lung tissue. This results in accumulation of blood and other fluids within the lung tissue. The excess fluid interferes with gas exchange leading to hypoxia. The pathophysiology of lung contusion includes ventilation/perfusion mismatching, increased intrapulmonary shunting, increased lung water, segmental lung damage, and a loss of compliance. Clinically, patient’s presents with hypoxiemia...

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

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Pyo; Lee, Jae Gue; Park, Ji Seon; Ryu, Kyung Nam [Kyunghee Univ., Seoul (Korea, Republic of)

    2004-02-01

    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), but differences in the prevalence and location of meniscal tears were not (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.

  9. PHLDA1 Promotes Lung Contusion by Regulating the Toll-Like Receptor 2 Signaling Pathway

    Directory of Open Access Journals (Sweden)

    Shaohua Wang

    2016-12-01

    Full Text Available Background/Aims: Lung contusion is a potentially lethal injury. Pleckstrin homology-like domain family A, member-1 (PHLDA1 is known to play crucial roles in cell proliferation and apoptosis. In this study, we investigated the biological role of PHLDA1 in lung contusion. Methods: The expression levels of PHLDA1 and TLR2 were detected by real time PCR and western. The cytokines were determined by ELISA. The inflammatory factors were detected by flow cytometry. The lung injury was determined by HE staining. Results: PHLDA1 gene and protein expression levels were up-regulated in a mouse lung-contusion model, together with increased neutrophil and macrophage contents. Down-regulation of PHLDA1 by interfering RNA (siPHLDA1 mice decreased lung injury and neutrophil infiltration. Inflammatory factors, including interleukin (IL-1β, IL-6, mouse homolog of human growth-regulated oncogene-α (KC, tumor necrosis factor-α, CC chemokine ligand (CCL 2, and CCL12 were also decreased in siPHLDA1 mice. Expression levels of Toll-like receptor 2 (TLR2 were increased in the lung-contusion mouse model, but were decreased when PHLDA1 was down-regulated. Conclusion: These results demonstrate that PHLDA1 plays a critical role in the development of progressive lung contusion and subsequent inflammation. This information furthers our understanding of the pathogenesis of lung contusion, and suggests that PHLDA1 blockade may represent a potential therapeutic strategy for the treatment of this injury.

  10. Time-dependent gene expression analysis after mouse skeletal muscle contusion

    Institute of Scientific and Technical Information of China (English)

    Weihua Xiao; Yu Liu; Beibei Luo; Linlin Zhao; Xiaoguang Liu; Zhigang Zeng; Peijie Chen

    2016-01-01

    Background: Though the mechanisms of skeletal muscle regeneration are deeply understood, those involved in muscle contusion, one of the most common muscle injuries in sports medicine clinics, are not. The objective of this study is to explore the mechanisms involved in muscle regeneration after contusion injury. Methods: In this study, a total of 72 mice were used. Eight of them were randomly chosen for the control group, while the rest were subjected to muscle contusion. Subsequently, their gastrocnemius muscles were harvested at different time points. The changes in muscle morphology were assessed by hematoxylin and eosin (HE) stain. In addition, the gene expression was analyzed by real-time polymerase chain reaction. Results: The data showed that the expression of many genes, i.e., specific markers of immune cells and satellite cells, regulatory factors for muscle regeneration, cytokines, and chemokines, increased in the early stages of recovery, especially in the first 3 days. Furthermore, there were strict rules in the expression of these genes. However, almost all the genes returned to normal at 14 days post-injury. 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.

  11. Pulmonary contusion is associated with TLR4 upregulation and decreased susceptibility to Pseudomonas pneumonia in a mouse model

    OpenAIRE

    Southard, Robert; Ghosh, Sarbani; Hilliard, Julia; Davis, Chris; Mazuski, Cristina; Walton, Andrew; Hotchkiss, Richard

    2012-01-01

    Pulmonary contusion is a major cause of respiratory failure in trauma patients. This injury frequently leads to immune suppression and infectious complications such as pneumonia. The mechanism whereby trauma leads to an immune suppressed state is poorly understood. To further study this phenomenon, we developed an animal model of pulmonary contusion complicated by pneumonia and assessed the effect of pulmonary contusion and pneumonia on toll-like receptor expression in alveolar macrophages. U...

  12. Perfusion and diffusion MRI study detecting CBF disturbance and edema formation in the acute phase of cerebral contusion

    Energy Technology Data Exchange (ETDEWEB)

    Kawamata, Tatsuro; Aoyama, Naoki; Mori, Tatsuro; Maeda, Takeshi; Katayama, Yoichi [Nihon Univ., Tokyo (Japan). School of Medicine

    1998-12-01

    In order to clarify the mechanisms underlying cerebral contusion-induced CBF disturbance and edema formation, echoplanar diffusion and perfusion images were obtained in the patients with cerebral contusion. In the acute phase within 48 hours post-trauma, the apparent diffusion coefficient (ADC) showed various levels with a tendency to increase in the central area of contusion (ADC ratio=1.06{+-}0.21). In contrast, the ADC was significantly reduced in the peripheral area of contusion (ADC ratio=0.87{+-}0.16). The ADC at 2 weeks post-trauma increased both in the central (ADC ratio=1.16{+-}0.26) and the peripheral area of contusion (ADC ratio=1.10{+-}0.26, p<0.05), as compared to those within 48 hours post-trauma. The perfusion images showed a wide spread CBF depression extending beyond the area of contusion observed on the T1 and T2 weighted images. These results indicate that; in the early phase of contusion-induced edema formation, cytotoxic edema is predominant, especially in the peripheral area of contusion, and vasogenic edema appears thereafter. The CBF depression may contribute such cytotoxic edema formation in the surrounding area of cerebral contusion. It is concluded that echo-planar diffusion and perfusion images are excellent technique to investigate the evolution of CBF disturbance and edema formation following traumatic brain injury. (author)

  13. A rat model for isolated bilateral lung contusion from blunt chest trauma.

    Science.gov (United States)

    Raghavendran, Krishnan; Davidson, Bruce A; Helinski, Jadwiga D; Marschke, Cristi J; Manderscheid, Patricia; Woytash, James A; Notter, Robert H; Knight, Paul R

    2005-11-01

    Lung contusion affects 17%-25% of adult blunt trauma patients, and is the leading cause of death from blunt thoracic injury. A small animal model for isolated bilateral lung contusion has not been developed. We induced lung contusion in anesthetized rats by dropping a 0.3-kg weight onto a precordial protective shield to direct the impact force away from the heart and toward the lungs. Lung injury was characterized as a function of chest impact energy (1.8-2.7 J) by measurements of arterial oxygenation, bronchoalveolar lavage (BAL) albumin and cytology, pressure-volume mechanics, and histopathology. Histology confirmed bilateral lung contusion without substantial cardiac muscle trauma. Rats receiving 2.7 J of chest impact energy had 33% mortality that exceeded prospectively defined limits for sublethal injury. Hypoxemia in rats with maximal sublethal injury (2.45 J) met criteria for acute lung injury at lung volumes at 48 h. We concluded that an impact energy of 2.45 J induces isolated, bilateral lung contusion and provides a useful model for future mechanistic pathophysiological assessments.

  14. In vivo imaging of spinal cord in contusion injury model mice by multi-photon microscopy

    Science.gov (United States)

    Oshima, Y.; Horiuchi, H.; Ogata, T.; Hikita, A.; Miura, H.; Imamura, T.

    2014-03-01

    Fluorescent imaging technique is a promising method and has been developed for in vivo applications in cellular biology. In particular, nonlinear optical imaging technique, multi-photon microscopy has make it possible to analyze deep portion of tissues in living animals such as axons of spinal code. Traumatic spinal cord injuries (SCIs) are usually caused by contusion damages. Therefore, observation of spinal cord tissue after the contusion injury is necessary for understanding cellular dynamics in response to traumatic SCI and development of the treatment for traumatic SCI. Our goal is elucidation of mechanism for degeneration of axons after contusion injuries by establishing SCI model and chronic observation of injured axons in the living animals. Firstly we generated and observed acute SCI model by contusion injury. By using a multi-photon microscope, axons in dorsal cord were visualized approximately 140 micron in depth from the surface. Immediately after injury, minimal morphological change of spinal cord was observed. At 3 days after injury, spinal cord was swelling and the axons seem to be fragmented. At 7 days after injury, increased degradation of axons could be observed, although the image was blurred due to accumulation of the connective tissue. In the present study, we successfully observed axon degeneration after the contusion SCI in a living animal in vivo. Our final goal is to understand molecular mechanisms and cellular dynamics in response to traumatic SCIs in acute and chronic stage.

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

    Directory of Open Access Journals (Sweden)

    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.

  16. Perfusion-CT for early assessment of traumatic cerebral contusions

    Energy Technology Data Exchange (ETDEWEB)

    Soustiel, Jean F.; Mahamid, Eugenia; Goldsher, Dorith; Zaaroor, Menashe [Faculty of Medicine, Technion - Israel Institute of Technology, Department of Neurosurgery, Rambam Medical Center, P.O. Box 9602, Haifa (Israel)

    2008-02-15

    To investigate the value of perfusion-CT (PCT) for assessment of traumatic cerebral contusions (TCC) and to compare the abilities of early noncontrast CT and PCT modalities to evaluate tissue viability. PCT studies performed in 30 patients suffering from TCC during the acute phase of their illness were retrospectively reviewed. Cerebral blood flow (CBF), volume (CBV) and mean transit time (MTT) were measured in three different areas: the hemorrhagic core of the TCC, the surrounding hypodense area and the perilesional normal-appearing parenchyma. TCC area was measured on CBF-, CBV- and MTT-derived maps and compared with the areas measured using the same slice obtained with CT scans performed on admission, at the time of PCT (follow-up CT) and at 1 week. TCC were characterized by low CBF and CBV values (9.2{+-}6.6 ml/100 g per min and 0.9{+-}0.7 ml/100 g, respectively) and a significant prolongation of MTT (11.9{+-}10.7 s) in the hemorrhagic core whereas PCT parameters were more variable in the hypodense area. The TCC whole area showed a noticeable growth of the lesions during the first week of admission. In comparison with early noncontrast CT, CBV and CBF maps proved to be more congruent with the findings of noncontrast CT scans at 1 week. PCT confirmed the results of xenon-CT studies and was shown to allow better evaluation of tissue viability than noncontrast CT. These findings suggest that PCT could be implemented in the future for the early assessment of patients with traumatic brain injury. (orig.)

  17. Therapeutic intraspinal microstimulation improves forelimb function after cervical contusion injury

    Science.gov (United States)

    Kasten, M. R.; Sunshine, M. D.; Secrist, E. S.; Horner, P. J.; Moritz, C. T.

    2013-08-01

    Objective. Intraspinal microstimulation (ISMS) is a promising method for activating the spinal cord distal to an injury. The objectives of this study were to examine the ability of chronically implanted stimulating wires within the cervical spinal cord to (1) directly produce forelimb movements, and (2) assess whether ISMS stimulation could improve subsequent volitional control of paretic extremities following injury. Approach. We developed a technique for implanting intraspinal stimulating electrodes within the cervical spinal cord segments C6-T1 of Long-Evans rats. Beginning 4 weeks after a severe cervical contusion injury at C4-C5, animals in the treatment condition received therapeutic ISMS 7 hours/day, 5 days/week for the following 12 weeks. Main results. Over 12 weeks of therapeutic ISMS, stimulus-evoked forelimb movements were relatively stable. We also explored whether therapeutic ISMS promoted recovery of forelimb reaching movements. Animals receiving daily therapeutic ISMS performed significantly better than unstimulated animals during behavioural tests conducted without stimulation. Quantitative video analysis of forelimb movements showed that stimulated animals performed better in the movements reinforced by stimulation, including extending the elbow to advance the forelimb and opening the digits. While threshold current to elicit forelimb movement gradually increased over time, no differences were observed between chronically stimulated and unstimulated electrodes suggesting that no additional tissue damage was produced by the electrical stimulation. Significance. The results indicate that therapeutic intraspinal stimulation delivered via chronic microwire implants within the cervical spinal cord confers benefits extending beyond the period of stimulation, suggesting future strategies for neural devices to promote sustained recovery after injury.

  18. The clinical outcome of occult pulmonary contusion on multidetector-row computed tomography in blunt trauma patients.

    NARCIS (Netherlands)

    Deunk, J.; Poels, T.C.; Brink, M.; Dekker, H.M.; Kool, D.R.; Blickman, J.G.; Vugt, A.B. van; Edwards, M.J.R.

    2010-01-01

    BACKGROUND: Multidetector-row computed tomography (MDCT) is a more sensitive modality as compared with conventional radiography (CR) in detecting pulmonary injuries. MDCT often detects pulmonary contusion that is not visualized by CR, defined as occult pulmonary contusion (OPC). The aim of this stud

  19. Exploring acute-to-chronic neuropathic pain in rats after contusion spinal cord injury.

    Science.gov (United States)

    Gaudet, Andrew D; Ayala, Monica T; Schleicher, Wolfgang E; Smith, Elana J; Bateman, Emily M; Maier, Steven F; Watkins, Linda R

    2017-09-01

    Spinal cord injury (SCI) causes chronic pain in 65% of individuals. Unfortunately, current pain management is inadequate for many SCI patients. Rodent models could help identify how SCI pain develops, explore new treatment strategies, and reveal whether acute post-SCI morphine worsens chronic pain. However, few studies explore or compare SCI-elicited neuropathic pain in rats. Here, we sought to determine how different clinically relevant contusion SCIs in male and female rats affect neuropathic pain, and whether acute morphine worsens later chronic SCI pain. First, female rats received sham surgery, or 150kDyn or 200kDyn midline T9 contusion SCI. These rats displayed modest mechanical allodynia and long-lasting thermal hyperalgesia. Next, a 150kDyn (1s dwell) midline contusion SCI was performed in male and female rats. Interestingly, males, but not females showed SCI-elicited mechanical allodynia; rats of both sexes had thermal hyperalgesia. In this model, acute morphine treatment had no significant effect on chronic neuropathic pain symptoms. Unilateral SCIs can also elicit neuropathic pain that could be exacerbated by morphine, so male rats received unilateral T13 contusion SCI (100kDyn). These rats exhibited significant, transient mechanical allodynia, but not thermal hyperalgesia. Acute morphine did not exacerbate chronic pain. Our data show that specific rat contusion SCI models cause neuropathic pain. Further, chronic neuropathic pain elicited by these contusion SCIs was not amplified by our course of early post-trauma morphine. Using clinically relevant rat models of SCI could help identify novel pain management strategies. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. PHLDA1 Promotes Lung Contusion by Regulating the Toll-Like Receptor 2 Signaling Pathway

    OpenAIRE

    2016-01-01

    Background/Aims: Lung contusion is a potentially lethal injury. Pleckstrin homology-like domain family A, member-1 (PHLDA1) is known to play crucial roles in cell proliferation and apoptosis. In this study, we investigated the biological role of PHLDA1 in lung contusion. Methods: The expression levels of PHLDA1 and TLR2 were detected by real time PCR and western. The cytokines were determined by ELISA. The inflammatory factors were detected by flow cytometry. The lung injury was determined by...

  1. [Diagnostics of lung contusion in patients with thoracic closed injury and prophylaxis of complications].

    Science.gov (United States)

    Rachko, Iu V

    2007-01-01

    Among 304 patients hospitalised with thorax closed injury 205 patients had lung contusion. The use of a complex diagnostics allowed to discharge 176 patients without any complications. The development of complections was observed in 128 patients, which occurred after the patients had had their injuries. Application of endoscopic sanation and treatment allowed to discharge patients in early terms.

  2. [Clinical Study on Cerebellar Contusion:A Report on 9 Cases and Literature Review].

    Science.gov (United States)

    Nashimoto, Takeo; Sasaki, Osamu; Nozawa, Takanori; Ando, Kazuhiro; Kikuchi, Bunpei; Watanabe, Masatoshi

    2015-10-01

    We report 9 cases of cerebellar contusion from April 2011 to September 2014 at our department. Frequency, clinicoradiological findings, mechanism of injury, treatments, and outcomes were retrospectively analyzed. Of 239 head injury cases admitted to our department during the same period, 9(3.8%)were diagnosed as cerebellar contusion. Among these 9 cases, 7 were men, and 2 were women. The patient age ranged from 12 to 83 years with a mean age of 64.7 years. The mechanism of injury was traffic accident in one patient, and fall in 8. All cases were associated with direct head trauma to the occiput, and radiographic studies showed occipital bone fracture in 8 cases. Six cases were managed conservatively. Three cases underwent suboccipital craniectomies and clot evacuations. Glasgow Outcome Scale(GOS)score at discharge were Good Recovery(GR)in 2, Moderate Disability(MD)in 2, Severe Disability(SD)in 3, Vegetative State(VS)in 1, and Dead(D)in 1. GOS scores in surgically treated cases were GR in 1, SD in 1, and VS in 1. Supratentorial severe traumatic lesions were concomitant with poor prognosis. Coup injury was a significant cause of cerebellar contusion. External decompression and clot evacuation were useful in patients who suffered severe cerebellar contusion;however, concomitant supratentorial lesions influenced the prognosis.

  3. Loss of central inhibition: implications for behavioral hypersensitivity after contusive spinal cord injury in rats.

    Science.gov (United States)

    Berrocal, Yerko A; Almeida, Vania W; Puentes, Rocio; Knott, Eric P; Hechtman, Jaclyn F; Garland, Mary; Pearse, Damien D

    2014-01-01

    Behavioral hypersensitivity is common following spinal cord injury (SCI), producing significant discomfort and often developing into chronic pain syndromes. While the mechanisms underlying the development of behavioral hypersensitivity after SCI are poorly understood, previous studies of SCI contusion have shown an increase in amino acids, namely, aspartate and glutamate, along with a decrease in GABA and glycine, particularly below the injury. The current study sought to identify alterations in key enzymes and receptors involved in mediating central inhibition via GABA and glycine after a clinically-relevant contusion SCI model. Following thoracic (T8) 25.0 mm NYU contusion SCI in rodents, significant and persistent behavioral hypersensitivity developed as evidenced by cutaneous allodynia and thermal hyperalgesia. Biochemical analyses confirmed upregulation of glutamate receptor GluR3 with downregulation of the GABA synthesizing enzyme (GAD65/67) and the glycine receptor α3 (GLRA3), notably below the injury. Combined, these changes result in the disinhibition of excitatory impulses and contribute to behavioral hyperexcitability. This study demonstrates a loss of central inhibition and the development of behavioral hypersensitivity in a contusive SCI paradigm. Future use of this model will permit the evaluation of different antinociceptive strategies and help in the elucidation of new targets for the treatment of neuropathic pain.

  4. Aquaporin 4 expression and ultrastructure of the blood-brain barrier following cerebral contusion injury

    Institute of Scientific and Technical Information of China (English)

    Xinjun Li; Yangyun Han; Hong Xu; Zhongshu Sun; Zengjun Zhou; Xiaodong Long; Yumin Yang; Linbo Zou

    2013-01-01

    This study aimed to investigate aquaporin 4 expression and the ultrastructure of the blood-brain barrier at 2–72 hours following cerebral contusion injury, and correlate these changes to the formation of brain edema. Results revealed that at 2 hours after cerebral contusion and laceration injury, aquaporin 4 expression significantly increased, brain water content and blood-brain barrier permeability increased, and the number of pinocytotic vesicles in cerebral microvascular endothelial cells increased. In addition, the mitochondrial accumulation was observed. As contusion and laceration injury became aggravated, aquaporin 4 expression continued to increase, brain water content and blood-brain barrier permeability gradually increased, brain capillary endothelial cells and astrocytes swelled, and capillary basement membrane injury gradually increased. The above changes were most apparent at 12 hours after injury, after which they gradually attenuated. Aquaporin 4 expression positively correlated with brain water content and the blood-brain barrier index. Our experimental findings indicate that increasing aquaporin 4 expression and blood-brain barrier permeability after cerebral contusion and laceration injury in humans is involved in the formation of brain edema.

  5. Loss of Central Inhibition: Implications for Behavioral Hypersensitivity after Contusive Spinal Cord Injury in Rats

    Directory of Open Access Journals (Sweden)

    Yerko A. Berrocal

    2014-01-01

    Full Text Available Behavioral hypersensitivity is common following spinal cord injury (SCI, producing significant discomfort and often developing into chronic pain syndromes. While the mechanisms underlying the development of behavioral hypersensitivity after SCI are poorly understood, previous studies of SCI contusion have shown an increase in amino acids, namely, aspartate and glutamate, along with a decrease in GABA and glycine, particularly below the injury. The current study sought to identify alterations in key enzymes and receptors involved in mediating central inhibition via GABA and glycine after a clinically-relevant contusion SCI model. Following thoracic (T8 25.0 mm NYU contusion SCI in rodents, significant and persistent behavioral hypersensitivity developed as evidenced by cutaneous allodynia and thermal hyperalgesia. Biochemical analyses confirmed upregulation of glutamate receptor GluR3 with downregulation of the GABA synthesizing enzyme (GAD65/67 and the glycine receptor α3 (GLRA3, notably below the injury. Combined, these changes result in the disinhibition of excitatory impulses and contribute to behavioral hyperexcitability. This study demonstrates a loss of central inhibition and the development of behavioral hypersensitivity in a contusive SCI paradigm. Future use of this model will permit the evaluation of different antinociceptive strategies and help in the elucidation of new targets for the treatment of neuropathic pain.

  6. Histopathological and behavioral characterization of a novel cervical spinal cord displacement contusion injury in the rat.

    Science.gov (United States)

    Pearse, D D; Lo, T P; Cho, K S; Lynch, M P; Garg, M S; Marcillo, A E; Sanchez, A R; Cruz, Y; Dietrich, W D

    2005-06-01

    Cervical contusive trauma accounts for the majority, of human spinal cord injury (SCI), yet experimental use of cervical contusion injury models has been limited. Considering that (1) the different ways of injuring the spinal cord (compression, contusion, and transection) induce very different processes of tissue damage and (2) the architecture of the spinal cord is not uniform, it is important to use a model that is more clinically applicable to human SCI. Therefore, in the current study we have developed a rat model of contusive, cervical SCI using the Electromagnetic Spinal Cord Injury Device (ESCID) developed at Ohio State University (OSU) to induce injury by spinal cord displacement. We used the device to perform mild, moderate and severe injuries (0.80, 0.95, and 1.1 mm displacements, respectively) with a single, brief displacement of <20 msec upon the exposed dorsal surface of the C5 cervical spinal cord of female (180-200 g) Fischer rats. Characterization of the model involved the analysis of the temporal histopathological progression of the injury over 9 weeks using histochemical stains to analyze white and gray mater integrity and immunohistochemistry to examine cellular changes and physiological responses within the injured spinal cord. Accompanying the histological analysis was a comprehensive determination of the behavioral functionality of the animals using a battery of motor tests. Characterization of this novel model is presented to enable and encourage its future use in the design and experimental testing of therapeutic strategies that may be used for human SCI.

  7. [Treatment outcome of surgical thoracic wall stabilization of the unstable thorax with and without lung contusion].

    Science.gov (United States)

    Voggenreiter, G; Neudeck, F; Aufmkolk, M; Obertacke, U; Schmit-Neuerburg, K P

    1996-06-01

    Between 1988 and 1994, 295 patients with blunt chest trauma were treated. Forty-two patients had flail chest, requiring mechanical ventilation. Open reduction and osteosynthesis (ASIF reconstruction plates or isoelastic rip clamps) of the chest wall were performed in 20 patients. For the purpose of analysis we separated the patients into five groups: group I (n = 10) had chest wall stabilization in flail chest without pulmonary contusion (average ISS 31.0, AIS-thorax 4.1); group II (n = 10) had chest wall stabilization in flail chest with pulmonary contusion (average ISS 37.0, AIS-thorax 4.3); group III (n = 18) had fail chest without pulmonary contusion (average ISS 36.3, AIS-thorax 4.2); group IV (n = 4) had flail chest with pulmonary contusion (average ISS 37.8, AIS-thorax 4.0); group V (n = 29) had pulmonary contusion without flail chest (average ISS 34.5. AIS-thorax 4.1). With open reduction and internal fixation of unstable chest wall segments, the duration of ventilatory support, mortality and pneumonia were significantly reduced to 6.5 (1-25) days in group I (mortality rate 0%, incidence of pneumonia 10%) compared to group III (duration of ventilatory support 26.7 days, mortality rate 39%, incidence of pneumonia 16%). Eighty percent of the patients in group I were extubated within 5 days postoperatively. In group II 4 patients underwent emergency thoracotomy for intrathoracic injuries (3 of them died between 4 h and 31 days) and 2 patients for laceration of the lung. In all these cases the chest wall was stabilized after thoracotomy. One patient was stabilized for a deformation of the chest wall and two for paradoxical movement of the chest wall during weaning from the respirator. The mean duration of ventilation in group II was 30.8 (10-112) days (mortality rate 30%, incidence of pneumonia 30%). No complications related to the osteosynthesis arose during the follow-up. In conclusion, the best indication for early operative chest wall stabilization is flail

  8. The Effects of Dexamethasone and L-NAME on Acute Lung Injury in Rats with Lung Contusion.

    Science.gov (United States)

    Kozan, Ahmet; Kilic, Nermin; Alacam, Hasan; Guzel, Ahmet; Guvenc, Tolga; Acikgoz, Mehmet

    2016-10-01

    The therapeutic efficiency of an anti-inflammatory agent, dexamethasone (DXM), and a nitric oxide synthase (NOS) inhibitor, Nitro-L-arginine methyl ester (L-NAME), in lung tissue injury after lung contusion was investigated. Serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), YKL-40, an inflammatory peptide, inducible NOS (iNOS), and Clara cell protein 16 (CC-16) were evaluated. Immunohistochemical analyses were also performed, and the lung tissue was examined histopathologically. The study consisted of eight groups of Sprague-Dawley rats (n = 10 in each group), weighing 250-300 g: (1) control, (2) contusion, (3) control + DXM, (4) contusion + DXM, (5) control + L-NAME (6) contusion + L-NAME, (7) control + DXM + L-NAME, and (8) contusion + DXM + L-NAME. A previously developed lung contusion model was used, in addition to the control group. The rats were administered DXM and L-NAME intraperitoneally (i.p.) at doses of 15 and 60 mg/kg/day, respectively. DXM and L-NAME administration decreased the iNOS level in the contusion groups. DXM increased the levels of YKL-40 and IL-10 in both the control and contusion groups, with higher levels in the contusion groups. L-NAME increased the serum level of IL-10 in the lung contusion groups. DXM increased the synthesis of CC-16 in the control and contusion groups. The combined use of a high-dose steroid and NOS inhibitor resulted in the death of the rats. Steroids can increase the level of cytokines, such as YKL-40 and IL-10, and the synthesis of CC-16 and prevent pneumonia, ALI/ARDS, and sepsis in lung contusion.

  9. Cerebral fat embolism: pulmonary contusion is a more important etiology than long bone fractures.

    Science.gov (United States)

    Aydin, M D; Akçay, F; Aydin, N; Gündogdu, C

    2005-01-01

    Lipid embolism is a serious and life-threatening problem and usually arises as a complication of severe trauma associated with long bone or pelvic fractures. It is generally thought that fat droplets enter the circulation at the site of fracture. In the systemic circulation, they become emboli to brain, kidney and other areas. Lipids are absorbed from the intestinal tract and transported into pulmonary tissue via thoracic duct and exposed to first catabolic procedures in the lungs. We have predicted that systemic lipid embolism may not occur unless bone fractures lead to pulmonary injury. This study was planned to investigate this hypothesis with respect to the role of pulmonary contusion and long bone fractures in the formation of cerebral fat embolism. Twenty male hybrid rabbits were included in this study. Pulmonary contusion was performed on half of the rabbits (n = 10) and femur fracture was applied to the remaining ones (n = 10). Ten days after procedure, all rabbits were sacrificed. Brain specimens were taken by frozen-section method and stained with Sudan black. Intraarteriolar lipid particles in the brain were examined microscopically. Cerebral fat embolism was detected in seven animals exposed to pulmonary contusion and only in one animal exposed to femur fracture. The mean number of branches of middle cerebral artery at midparietal level occluded with fat particles were higher in the pulmonary contusion group than in the long bone fracture group. In conclusion, we found that pulmonary contusion had more deleterious effects than long bone fracture in the formation of cerebral fat embolism.

  10. Toll-like receptor 4 dependent responses to lung injury in a murine model of pulmonary contusion

    OpenAIRE

    2009-01-01

    Blunt chest trauma resulting in pulmonary contusion with an accompanying acute inflammatory response is a common but poorly understood injury. We previously demonstrated that toll-like receptor 2 participates in the inflammatory response to lung injury. We hypothesized that the toll-like receptor 4, in a MyD88-dependent manner, may also participate in the response to lung injury. To investigate this, we used a model of pulmonary contusion in the mouse that is similar to that observed clinical...

  11. [Pulmonary contusion and acute respiratory distress syndrome (ARDS) as complications of blunt chest trauma].

    Science.gov (United States)

    Michalska, Agata; Jurczyk, Agnieszka P; Machała, Waldemar; Szram, Stefan; Berent, Jarosław

    2009-01-01

    Blunt chest traumas are common nowadays due to development of motor transport. They are associated with high mortality rates because of serious injuries of internal organs. The mechanisms of injuries are complex and may cause damages ranging from small ones, such as bruises or abrasions, to life-threatening trauma. Among typical injuries there are rib fractures, sternal fractures, pneumothorax, hemothorax, diaphragm lacerations, pulmonary contusions, cardiac tamponade, cardiac rupture and many others. The authors of the article would like to emphasize the pathophysiology and diagnostic difficulties in such blunt chest trauma complications as pulmonary contusions and acute respiratory distress syndrome, for which no causal treatment is available and only early diagnosis and administration of symptomatic treatment may increase the patients' chances to survive. In Forensic Medicine Department, Medical University of Łódź, an opinion was issued on a case which illustrates the clinical problem.

  12. Perilesional reorganization of somatosensory function following traumatic cortical contusion A case report

    Institute of Scientific and Technical Information of China (English)

    Mi Young Lee; Sung Ho Jang

    2011-01-01

    The present study reports on a 23-year-old male patient with somatosensory dysfunction of the left hand following cortical contusion. His somatosensory dysfunction recovered to a nearly normal state at 6 months after injury. Functional MRI results demonstrated that the contralateral primary sensorimotor cortex centered on the primary somatosensroy cortex was activated during touch stimulation of the patient's right hand and either hand of control subjects. By contrast, the anterior area of the lesion centered on the precentral knob in the right hemisphere was activated during touch stimulation of the left hand. These findings show that the somatosensory function of the affected hand appears to have been recovered by the somatosensory cortex reorganizing into the anterior area of the contused primary somatosensory cortex.

  13. Early onset pneumonia following pulmonary contusion: the case of Stonewall Jackson.

    Science.gov (United States)

    Lively, Mathew W

    2012-03-01

    Confederate Lieutenant General Thomas J. "Stonewall" Jackson was wounded by his own men at the Battle of Chancellorsville during the American Civil War. While being removed from the field, Jackson fell from the litter and struck the right side of his chest on a large stone or stump. Four days following the amputation of his left arm, Jackson developed pneumonia in his right lung. His treating physicians believed the infection developed secondary to a pulmonary contusion that occurred when he fell from the litter. Pulmonary contusions are an independent risk factor in the development of post-traumatic pneumonia and an infection that occurs within 72 to 96 hours of injury is termed an early onset pneumonia. The nature and timing of Stonewall Jackson's illness following his wounding is consistent with the modem diagnosis of early onset pneumonia following chest trauma.

  14. Electroporation-mediated Delivery of Genes in Rodent Models of Lung Contusion

    OpenAIRE

    2014-01-01

    Several of the biological processes involved in the pathogenesis of acute lung injury and acute respiratory distress syndrome after lung contusion are regulated at a genetic and epigenetic level. Thus, strategies to manipulate gene expression in this context are highly desirable not only to elucidate the mechanisms involved but also to look for potential therapies. In the present chapter, we describe mouse and rat models of inducing blunt thoracic injury followed by electroporation-mediated g...

  15. Early neurosurgical intervention of spinal cord contusion: an analysis of 30 cases

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background The incidence of spinal injury with spinal cord contusion is high in developed countries and is now growing in China. Furthermore, spinal cord injury happens mostly in young people who have a long life expectance. A large number of patients thus are wheelchair bound for the rest of their lives. Therefore, spinal cord injury has aroused great concern worldwide. Despite great efforts, recovery from spinal cord injury remains unsatisfactory. Based on the pathology of spinal cord contusion, an idea of early neurosurgical intervention has been formulated in this study. Methods A total of 30 patients with "complete" spinal cord injury or classified as American Spinal Injury Association (ASIA)-A were studied. Orthopedic treatment of the injured vertebra(e), internal fixation of the vertebral column, and bilateral laminectomy for epidural decompression were followed directly by neurosurgical management, including separation of the arachnoid adhesion to restore cerebrospinal fluid flow and debridement of the spinal cord necrotic tissue with concomitant intramedullary decompression. Rehabilitation started 17 days after the operation. The final outcome was evaluated after 3 months of rehabilitation. Pearson chi-square analysis was used for statistical analysis. Results All the patients recovered some ability to walk. The least recovered patients were able to walk with a wheeled weight support and help in stabilizing the weight bearing knee joint (12 cases, 40%). Thirteen patients (43%) were able to walk with a pair of crutches, a stick or without any support. The timing of the operation after injury was important. An optimal operation time window was identified at 4-14 days after injury. Conclusions Early neurosurgical intervention of spinal cord contusion followed by rehabilitation can significantly improve the locomotion of the patients. It is a new idea of a therapeutic approach for spinal cord contusion and has been proven to be very successful.

  16. Vitamin C as an antioxidant: evaluation of its role on pulmonary contusion experimental model

    OpenAIRE

    SIRMALI, Rana; GİNİŞ, Zeynep; Mehmet SIRMALI; Solak, Okan; ŞELİMAN, Bengü; Yetkin AĞAÇKIRAN; DELİBAŞ, Namık

    2014-01-01

    To analyze the protective activity of vitamin C on the lungs by assessing biochemical and histopathological analysis after performing an experimental isolated lung contusion model. Materials and methods: Fifty-four male Sprague-Dawley male rats were used. The rats were randomly separated into 4 groups. Vitamin C (200 mg/kg) was injected intraperitoneally 30 min after trauma. Blood samples were obtained for myeloperoxidase (MPO), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), a...

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Localized vitreous adhesion to the retina after ocular contusion with a baseball

    Directory of Open Access Journals (Sweden)

    Kimura M

    2012-06-01

    Full Text Available Masayo Kimura, Akira Nishimura, Kazuhisa SugiyamaDepartment of Ophthalmology and Visual Science, Kanazawa University Graduate School of Medical Science, Kanazawa, JapanPurpose: To report a series of five cases of vitreous adhesions after blunt trauma caused by a baseball strike.Methods: The medical records of patients with ocular contusion after being struck by a baseball, who had undergone pars plana vitrectomy, were reviewed. An aqueous suspension of triamcinolone acetonide was used intraoperatively to facilitate visualization of the vitreous.Results: Five eyes were reviewed in this study. There were two cases of retinal detachment, two cases of traumatic macular hole, and one case of retinal detachment due to traumatic macular hole. Despite the surgical creation of posterior vitreous detachment, if not already present, the thin layer of localized vitreous adhesion to the retinal necrotic area with/without retinal hole was found between the major vascular arcades and the equator in all cases. The thin layer of the vitreous was removed with a vitreous cutter and diamond-dusted membrane scraper, but complete removal was impossible.Conclusions: A thin layer of localized vitreous adhesion at the area of retinal degeneration was observed in eyes following ocular contusion.Keywords: localized, vitreous adhesion, triamcinolone acetonide, ocular contusion, pars plana vitrectomy

  19. Neurodegenerative diversity in human cortical contusion: histological analysis of tissue derived from decompressive craniectomy.

    Science.gov (United States)

    Riascos, David; Buriticá, Efraín; Jiménez, Eliecer; Castro, Olagide; Guzmán, Francisco; Palacios, Mauricio; Garcia-Cairasco, Norberto; Geula, Changiz; Escobar, Martha; Pimienta, Hernán

    2013-11-06

    The principal aim in the management of patients with cerebral contusion (CC) following severe traumatic brain injury (TBI) is the prevention, amelioration, and treatment of secondary neuronal dysfunction and pathology. Distinguishing between irreversibly damaged and surviving tissue could have considerable therapeutic and prognostic implications for patients. To characterize structurally the neuronal compartment of the contused region in samples derived from patients who suffered severe TBI and were subjected to decompressive craniectomy, we used NeuN, a neuronal marker. We determined that NeuN "patches", sectors with loss of NeuN immunoreactivity (NeuN-IR), represented 25% of the area among the analyzed cases. We also found a 67% decrease in NeuN levels via Western blot. Tissue adjoining patches of NeuN-IR were considered "preserved" due to the apparent normal density of neurons and conservation of the six cortical layers. Nevertheless, these sectors retained only 39% of their neurons with the classical pattern described for normal NeuN-IR. Using Fluorojade we identified a 16-fold increase in density of moribund neurons in "preserved" sectors when compared to controls. Additionally these abnormalities were enhanced 5-fold in "patches" of NeuN-IR when compared to preserved regions. Therefore, NeuN/Fluorojade abnormalities are indicative of different cell fates characteristic of CC tissue. This analysis addressed exclusively the neuronal compartment and provides new insights into the degenerative state of neurons in the contused region that is likely to contribute to clinical outcome and differentiate TBI from ischemia.

  20. Innate immune response to pulmonary contusion: identification of cell type-specific inflammatory responses.

    Science.gov (United States)

    Hoth, J Jason; Wells, Jonathan D; Yoza, Barbara K; McCall, Charles E

    2012-04-01

    Lung injury from pulmonary contusion is a common traumatic injury, predominantly seen after blunt chest trauma, such as in vehicular accidents. The local and systemic inflammatory response to injury includes activation of innate immune receptors, elaboration of a variety of inflammatory mediators, and recruitment of inflammatory cells to the injured lung. Using a mouse model of pulmonary contusion, we had previously shown that innate immune Toll-like receptors 2 and 4 (TLR2 and TLR4) mediate the inflammatory response to lung injury. In this study, we used chimeric mice generated by adoptive bone marrow transfer between TLR2 or TLR4 and wild-type mice. We found that, in the lung, both bone marrow-derived and nonmyeloid cells contribute to TLR-dependent inflammatory responses after injury in a cell type-specific manner. We also show a novel TLR2-dependent injury mechanism that is associated with enhanced airway epithelial cell apoptosis and increased pulmonary FasL and Fas expression in the lungs from injured mice. Thus, in addition to cardiopulmonary physiological dysfunction, cell type-specific TLR and their differential response to injury may provide novel specific targets for management of patients with pulmonary contusion.

  1. Endoscopy-assisted cerebral falx incision via unilateral approach for treatment of dissymmetric bilateral frontal contusion

    Institute of Scientific and Technical Information of China (English)

    DONG Ji-rong; HU Xu; XU Qin-yi; CAI Xue-jian; WANG Biao; WANG Yu-hai; SHI Zhong-hua; LIU Bing; CAI Sang; HE Jian-qing

    2012-01-01

    Objective: To investigate the clinical features and treatment strategy of dissymmetric bilateral frontal contusion,and to summarize our experience in treating these patients by minimally invasive surgery.Methods: Over the past 3 years,we have treated a total of 31 patients with dissymmetric bilateral frontal contusion using endoscopy-assisted unilateral cerebral falx incision.Other 30 patients treated by routine bilateral approaches within the same period were taken as control.Results: Seventeen cases (54.8%) in the unilateral operation group survived and were in good condition,8 (25.8%) had moderate disability,4 (12.9%) had severe disability,1 (3.2%) was in vegetative state,and 1 (3.2%) died.Compared with the control group,the Glasgow Outcome Scale score was not significantly different in the unilateral operation group,but the operation time,blood transfusion volume,the length of hospital stay,the incidences of mental disorder and olfactory nerve injury were greatly reduced in the unilateral operation group.Conclusions: Endoscopy-assisted unilateral cerebral falx incision can shorten the operation time,reduce surgical trauma and complications in treatment of patients with dissymmetric bilateral frontal contusion.It can obviously diminish the chance of delayed intracerebral hematoma and subsequently minimize the incidences of subfalcial and centrencephalic herniation.

  2. Chronic Prosopis glandulosa treatment blunts neutrophil infiltration and enhances muscle repair after contusion injury.

    Science.gov (United States)

    George, Cindy; Smith, Carine; Isaacs, Ashwin W; Huisamen, Barbara

    2015-01-23

    The current treatment options for soft tissue injuries remain suboptimal and often result in delayed/incomplete recovery of damaged muscle. The current study aimed to evaluate the effects of oral Prosopis glandulosa treatment on inflammation and regeneration in skeletal muscle after contusion injury, in comparison to a conventional treatment. The gastrocnemius muscle of rats was subjected to mass-drop injury and muscle samples collected after 1-, 3 h, 1- and 7 days post-injury. Rats were treated with P. glandulosa (100 mg/kg/day) either for 8 weeks prior to injury (up until day 7 post-injury), only post-injury, or with topically applied diclofenac post-injury (0.57 mg/kg). Neutrophil (His48-positive) and macrophage (F4/80-positive) infiltration was assessed by means of immunohistochemistry. Indicators of muscle satellite cell proliferation (ADAM12) and regeneration (desmin) were used to evaluate muscle repair. Chronic P. glandulosa and diclofenac treatment (p<0.0001) was associated with suppression of the neutrophil response to contusion injury, however only chronic P. glandulosa treatment facilitated more effective muscle recovery (increased ADAM12 (p<0.05) and desmin (p<0.001) expression), while diclofenac treatment had inhibitory effects on repair, despite effective inhibition of neutrophil response. Data indicates that P. glandulosa treatment results in more effective muscle repair after contusion.

  3. The effect of muscle contusion on cortical bone and muscle perfusion following reamed, intramedullary nailing: a novel canine tibia fracture model

    Directory of Open Access Journals (Sweden)

    Zdero Rad

    2010-11-01

    Full Text Available Abstract Background Management of tibial fractures associated with soft tissue injury remains controversial. Previous studies have assessed perfusion of the fractured tibia and surrounding soft tissues in the setting of a normal soft tissue envelope. The purpose of this study was to determine the effects of muscle contusion on blood flow to the tibial cortex and muscle during reamed, intramedullary nailing of a tibial fracture. Methods Eleven adult canines were distributed into two groups, Contusion or No-Contusion. The left tibia of each canine underwent segmental osteotomy followed by limited reaming and locked intramedullary nailing. Six of the 11 canines had the anterior muscle compartment contused in a standardized fashion. Laser doppler flowmetry was used to measure cortical bone and muscle perfusion during the index procedure and at 11 weeks post-operatively. Results Following a standardized contusion, muscle perfusion in the Contusion group was higher compared to the No-Contusion group at post-osteotomy and post-reaming (p 0.05. There was a sustained decrease in overall bone perfusion in the Contusion group at 11 weeks, compared to the No-Contusion group (p Conclusions Injury to the soft tissue envelope may have some deleterious effects on intraosseous circulation. This could have some influence on the fixation method for tibia fractures linked with significant soft tissue injury.

  4. Distinct time courses of secondary brain damage in the hippocampus following brain concussion and contusion in rats.

    Science.gov (United States)

    Nakajima, Yuko; Horiuchi, Yutaka; Kamata, Hiroshi; Yukawa, Masayoshi; Kuwabara, Masato; Tsubokawa, Takashi

    2010-07-01

    Secondary brain damage (SBD) is caused by apoptosis after traumatic brain injury that is classified into concussion and contusion. Brain concussion is temporary unconsciousness or confusion caused by a blow on the head without pathological changes, and contusion is a brain injury with hemorrhage and broad extravasations. In this study, we investigated the time-dependent changes of apoptosis in hippocampus after brain concussion and contusion using rat models. We generated the concussion by dropping a plumb on the dura from a height of 3.5 cm and the contusion by cauterizing the cerebral cortex. SBD was evaluated in the hippocampus by histopathological analyses and measuring caspase-3 activity that induces apoptotic neuronal cell death. The frequency of abnormal neuronal cells with vacuolation or nuclear condensation, or those with DNA fragmentation was remarkably increased at 1 hr after concussion (about 30% for each abnormality) from the pre-injury level (0%) and reached the highest level (about 50% for each) by 48 hrs, whereas the frequency of abnormal neuronal cells was increased at 1 hr after contusion (about 10%) and reached the highest level (about 40%) by 48 hrs. In parallel, caspase-3 activity was increased sevenfold in the hippocampus at 1 hr after concussion and returned to the pre-injury level by 48 hrs, whereas after contusion, caspase-3 activity was continuously increased to the highest level at 48 hrs (fivefold). Thus, anti-apoptotic-cell-death treatment to prevent SBD must be performed by 1 hr after concussion and at latest by 48 hrs after contusion.

  5. Toll-like receptor 2 participates in the response to lung injury in a murine model of pulmonary contusion.

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    Hoth, J Jason; Hudson, William P; Brownlee, Noel A; Yoza, Barbara K; Hiltbold, Elizabeth M; Meredith, J Wayne; McCall, Charles E

    2007-10-01

    Blunt chest trauma resulting in pulmonary contusion with an accompanying acute inflammatory response is a common but poorly understood injury. We report that Toll-like receptor (TLR) 2 participates in the inflammatory response to lung injury. To show this, we use a model of pulmonary contusion in the mouse that is similar to that observed clinically in humans based on histologic, morphologic, and biochemical criteria of acute lung injury. The inflammatory response to pulmonary contusion in our mouse model is characterized by pulmonary edema, neutrophil transepithelial migration, and increased expression of the innate immunity proinflammatory cytokines IL 1beta and IL 6, the adhesion intracellular adhesion molecule 1, and chemokine (CXC motif) ligand 1. Compared with wild-type animals, contused Tlr2(-/-) mice have significantly reduced pulmonary edema and neutrophilia. These findings are associated with decreased levels of circulating chemokine (CXC motif) ligand 1. In contrast, systemic IL 6 levels remain elevated in the TLR2-deficient phenotype. These results show that TLR2 has a primary role in the neutrophil response to acute lung injury. We suggest that an unidentified noninfectious ligand generated by pulmonary contusion acts via TLR2 to generate inflammatory responses.

  6. Toll-like receptor 4-dependent responses to lung injury in a murine model of pulmonary contusion.

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    Hoth, J Jason; Wells, Jonathan D; Brownlee, Noel A; Hiltbold, Elizabeth M; Meredith, J Wayne; McCall, Charles E; Yoza, Barbara K

    2009-04-01

    Blunt chest trauma resulting in pulmonary contusion with an accompanying acute inflammatory response is a common but poorly understood injury. We previously demonstrated that toll-like receptor 2 (TLR-2) participates in the inflammatory response to lung injury. We hypothesized that the TLR-4, in an MyD88-dependent manner, may also participate in the response to lung injury. To investigate this, we used a model of pulmonary contusion in the mouse that is similar to that observed clinically in humans and evaluated postinjury lung function, pulmonary neutrophil recruitment, and the systemic innate immune response. Comparisons were made between wild-type mice and mice deficient in TLR-4 or MyD88. We found TLR-4-dependent responses to pulmonary contusion that include hypoxemia, edema, and neutrophil infiltration. Increased expression of IL-6 and chemokine (C-X-C motif) ligand 1 in the bronchoalveolar lavage and serum was also dependent on TLR-4 activation. We further demonstrated that these responses to pulmonary contusion were dependent on MyD88, an adapter protein in the signal transduction pathway mediated by TLRs. These results show that TLRs have a primary role in the response to acute lung injury. Lung inflammation and systemic innate immune responses are dependent on TLR activation by pulmonary contusion.

  7. The evolution of isolated bilateral lung contusion from blunt chest trauma in rats: cellular and cytokine responses.

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    Raghavendran, Krishnan; Davidson, Bruce A; Woytash, James A; Helinski, Jadwiga D; Marschke, Cristi J; Manderscheid, Patricia A; Notter, Robert H; Knight, Paul R

    2005-08-01

    Lung contusion is the leading cause of death from blunt thoracic trauma in adults, but its mechanistic pathophysiology remains unclear. This study uses a recently developed rat model to investigate the evolution of inflammation and injury in isolated lung contusion. Bilateral lung contusion with minimal cardiac trauma was induced in 54 anesthetized rats by dropping a 0.3-kg hollow cylindrical weight onto a precordial shield (impact energy, 2.45 Joules). Arterial oxygenation, pressure-volume (P-V) mechanics, histology, and levels of erythrocytes, leukocytes, albumin, and inflammatory mediators in bronchoalveolar lavage (BAL) were assessed at 8 min, at 4, 12, 24, and 48 h, and at 7 days after injury. The role of neutrophils in the evolution of inflammatory injury was also specifically studied by depleting these cells with intravenous vinblastine before lung contusion. Arterial oxygenation was severely reduced at 8 min to 24 h postcontusion, but became almost normal by 48 h. Levels of erythrocytes, leukocytes, and albumin in BAL were increased at lung injury based on total lung volume at 4 h and on BAL albumin levels at 24 h postcontusion. Inflammatory injury from isolated bilateral lung contusion in rats is most severe in the acute period (8 min-24 h) after initial blunt trauma, and includes a component of neutrophil-dependent pathology.

  8. The Time Course Effects of Electroacupuncture on Promoting Skeletal Muscle Regeneration and Inhibiting Excessive Fibrosis after Contusion in Rabbits

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    Rongguo Wang

    2013-01-01

    Full Text Available The aim of this study was to investigate the longitudinal effects of electroacupuncture (EA on Zusanli (ST36 and Ashi acupoints in promoting skeletal muscle regeneration and inhibiting excessive fibrosis after contusion in rabbits. Sixty rabbits were randomly divided into four groups: normal, contusion, EA, and recombinant human insulin-like growth factor-I (rhIGF-I. An acute skeletal muscle contusion was produced on the right gastrocnemius (GM by an instrument-based drop-mass technique. EA was performed for 15 minutes every two days with 0.4 mA (2 Hz, and GM injections were executed with rhIGF-I (0.25 mL once a week. Rabbits treated with EA had a higher T-SOD and T-AOC serum activities and lower MDA serum level, the blood perfusion of which was also significantly higher. In the EA group, the diameter of the myofibril was uniform and the arrangement was regular, contrary to the contusion group. The number and diameter of regenerative myofibers and MHC expression were increased in the EA group. EA treatment significantly decreased fibrosis formation and reduced both GDF-8 and p-Smad2/3 expressions in injured muscle. Our data indicate that EA may promote myofiber regeneration and reduce excessive fibrosis by improving blood flow and antioxidant capacities. Additionally, EA may regulate signaling factor expression after contusion.

  9. The swimming test is effective for evaluating spasticity after contusive spinal cord injury

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    Ryu, Youngjae; Ogata, Toru; Nagao, Motoshi; Kitamura, Taku; Morioka, Kazuhito; Ichihara, Yoshinori; Doi, Toru; Sawada, Yasuhiro; Akai, Masami; Nishimura, Ryohei; Fujita, Naoki

    2017-01-01

    Spasticity is a frequent chronic complication in individuals with spinal cord injury (SCI). However, the severity of spasticity varies in patients with SCI. Therefore, an evaluation method is needed to determine the severity of spasticity. We used a contusive SCI model that is suitable for clinical translation. In this study, we examined the feasibility of the swimming test and an EMG for evaluating spasticity in a contusive SCI rat model. Sprague-Dawley rats received an injury at the 8th thoracic vertebra. Swimming tests were performed 3 to 6 weeks after SCI induction. We placed the SCI rats into spasticity-strong or spasticity-weak groups based on the frequency of spastic behavior during the swimming test. Subsequently, we recorded the Hoffman reflex (H-reflex) and examined the immunoreactivity of serotonin (5-HT) and its receptor (5-HT2A) in the spinal tissues of the SCI rats. The spasticity-strong group had significantly decreased rate-dependent depression of the H-reflex compared to the spasticity-weak group. The area of 5-HT2A receptor immunoreactivity was significantly increased in the spasticity-strong group. Thus, both electrophysiological and histological evaluations indicate that the spasticity-strong group presented with a more severe upper motor neuron syndrome. We also observed the groups in their cages for 20 hours. Our results suggest that the swimming test provides an accurate evaluation of spasticity in this contusive SCI model. We believe that the swimming test is an effective method for evaluating spastic behaviors and developing treatments targeting spasticity after SCI. PMID:28182676

  10. 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

  11. The swimming test is effective for evaluating spasticity after contusive spinal cord injury.

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    Ryu, Youngjae; Ogata, Toru; Nagao, Motoshi; Kitamura, Taku; Morioka, Kazuhito; Ichihara, Yoshinori; Doi, Toru; Sawada, Yasuhiro; Akai, Masami; Nishimura, Ryohei; Fujita, Naoki

    2017-01-01

    Spasticity is a frequent chronic complication in individuals with spinal cord injury (SCI). However, the severity of spasticity varies in patients with SCI. Therefore, an evaluation method is needed to determine the severity of spasticity. We used a contusive SCI model that is suitable for clinical translation. In this study, we examined the feasibility of the swimming test and an EMG for evaluating spasticity in a contusive SCI rat model. Sprague-Dawley rats received an injury at the 8th thoracic vertebra. Swimming tests were performed 3 to 6 weeks after SCI induction. We placed the SCI rats into spasticity-strong or spasticity-weak groups based on the frequency of spastic behavior during the swimming test. Subsequently, we recorded the Hoffman reflex (H-reflex) and examined the immunoreactivity of serotonin (5-HT) and its receptor (5-HT2A) in the spinal tissues of the SCI rats. The spasticity-strong group had significantly decreased rate-dependent depression of the H-reflex compared to the spasticity-weak group. The area of 5-HT2A receptor immunoreactivity was significantly increased in the spasticity-strong group. Thus, both electrophysiological and histological evaluations indicate that the spasticity-strong group presented with a more severe upper motor neuron syndrome. We also observed the groups in their cages for 20 hours. Our results suggest that the swimming test provides an accurate evaluation of spasticity in this contusive SCI model. We believe that the swimming test is an effective method for evaluating spastic behaviors and developing treatments targeting spasticity after SCI.

  12. Electroporation-mediated delivery of genes in rodent models of lung contusion.

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    Machado-Aranda, David; Raghavendran, Krishnan

    2014-01-01

    Several of the biological processes involved in the pathogenesis of acute lung injury and acute respiratory distress syndrome after lung contusion are regulated at a genetic and epigenetic level. Thus, strategies to manipulate gene expression in this context are highly desirable not only to elucidate the mechanisms involved but also to look for potential therapies. In the present chapter, we describe mouse and rat models of inducing blunt thoracic injury followed by electroporation-mediated gene delivery to the lung. Electroporation is a highly efficient and easily reproducible technique that allows circumvention of several of lung gene delivery challenges and safety issues present with other forms of lung gene therapy.

  13. Finite element-based injury metrics for pulmonary contusion via concurrent model optimization.

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    Gayzik, F Scott; Hoth, J Jason; Stitzel, Joel D

    2011-07-01

    This study explores the relationship between impact severity and resulting pulmonary contusion (PC) for four impact conditions using a rat model of the injury. The force-deflection response from a Finite Element (FE) model of the lung was simultaneously matched to experimental data from distinct impacts via a genetic algorithm optimization. Sprague-Dawley rats underwent right-side thoracotomy prior to impact. Insults were applied directly to the lung via an instrumented piston. Five cohorts were tested: a sham group and four groups experiencing lung insults of varying degrees of severity. The values for impact velocity (V) and penetration depth (D) of the cohorts were Group 1, (V = 6.0 m · s(-1), D = 5.0 mm), Group 2, (V = 1.5 m · s(-1),D = 5.0 mm), Group 3, (V = 6 m · s(-1), D = 2.0 mm), and Group 4, (V = 1.5 m · s(-1), D = 2.0 mm). CT scans were acquired at 24 h, 48 h, and 1 week post-insult. Contusion volume was determined through segmentation. FE-based injury metrics for PC were determined at 24 h and 1 week post-impact, based on the observed volume of contusion and first principal strain. At 24 h post-impact, the volume of high radiopacity lung (HRL) was greatest for the severe impact group (mean HRL = 9.21 ± 4.89) and was significantly greater than all other cohorts but Group 3. The concurrent optimization matched simulated and observed impact energy within one standard deviation for Group 1 (energy = 3.88 ± 0.883 mJ, observed vs. 4.47 mJ, simulated) and Group 2 (energy = 1.46 ± 0.403 mJ, observed vs. 1.50 mJ, simulated) impacts. Statistically significant relationships between HRL and impact energy are presented. The FEA-based injury metrics at 24 h post-contusion are ε(max) · ε(max) exceeding 94.5 s(-1), ε (max) exceeding 0.284 and ε(max) exceeding 470 s(-1). Thresholds for injury to the lung still present at 1 week post-impact were also determined. They are ε(max) · ε(max) exceeding 149 s(-1), ε (max) exceeding 0.343 and ε(max) exceeding

  14. Robotic gait analysis of bipedal treadmill stepping by spinal contused rats: characterization of intrinsic recovery and comparison with BBB.

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    Nessler, Jeff A; De Leon, Ray D; Sharp, Kelli; Kwak, Eugene; Minakata, Koyiro; Reinkensmeyer, David J

    2006-06-01

    There is a critical need to develop objective, quantitative techniques to assess motor function after spinal cord injury. Here, we assess the ability of a recently developed robotic device (the "rat stepper") to characterize locomotor impairment following contusion injury in rats. In particular, we analyzed how the kinematic features of hindlimb movement during bipedal, weight-supported treadmill stepping change following contusion, and whether these changes correlate with the recovery of open field locomotion. Female, Sprague-Dawley rats (n=29, 8 weeks of age) received mid thoracic contusion injuries of differing severities (11 mild, nine moderate, nine severe, and four sham). In a first experiment, 16 of the animals were evaluated weekly for 12 weeks using the robotic stepping device. In a second experiment, 17 of the animals were evaluated every other day for 4 weeks. The contused animals recovered open field locomotion based on the Basso, Beattie, and Bresnahan Scale (BBB) analysis, with most of the recovery occurring by 4 weeks post-injury. Analysis of 14 robotic measures of stepping revealed that several measures improved significantly during the same 4 weeks: swing velocity, step height, step length, hindlimb coordination, and the ability to support body weight. These measures were also significantly correlated with the BBB score. The number of steps taken during testing was not directly related to intrinsic recovery or correlated to the BBB score. These results suggest that it is the quality of weight-supported steps, rather than the quantity, that best reflects locomotor recovery after contusion injury, and that the quality of these steps is determined by the integrity of extensor, flexor, and bilateral coordination pathways. Thus, by measuring only a few weight-supported steps with motion capture, a sensitive, valid measure of locomotor recovery following contusion injury can be obtained across a broad range of impairment levels.

  15. Correlating the extent of pulmonary contusion to vehicle crash parameters in near-side impacts.

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    Danelson, Kerry A; Chiles, Caroline; Thompson, Aaron B; Donadino, Katherine; Weaver, Ashley A; Stitzel, Joel D

    2011-01-01

    Pulmonary contusion (PC) is the most common injury following blunt thoracic trauma with an associated mortality of 10% to 20%. The purpose of this study is to determine how crash parameters correlate to the volume of pulmonary contusion. The Crash Injury Research Engineering and Network (CIREN) database was queried to extract data on all occupants sustaining PC in a near-side crash. The selected CIREN data included all completed cases from 2005 through 2010. Cases involving a roll-over or without a thorax CT uploaded to the database were excluded. After all cases had been examined the study had 64 occupants with varying volumes of PC. Specific crash characteristics compiled included change in velocity due to the impact, energy, occupant characteristics, side airbag deployment, and crush profile measurements. Crush metrics quantifying the area of the crush profile and the location of the crush relative to the occupant were calculated. The thoracic CT scans from these cases were downloaded and segmented to determine the percent volume of high attenuation lung and PC as compared to the total volume of the lung. The results of the general linear model analysis suggest that maximum crush was the best predictor of high attenuation lung and lung location best predicted PC. An analysis of NASS and CIREN demonstrated that crashes with PC tended to have crash parameters that indicated higher severity. These correlations can be used in the future to develop an injury criterion for PC using finite element metrics.

  16. The monoacylglycerol lipase inhibitor JZL184 decreases inflammatory response in skeletal muscle contusion in rats.

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    Jiang, Shu-Kun; Zhang, Miao; Tian, Zhi-Ling; Wang, Meng; Zhao, Rui; Wang, Lin-Lin; Li, Shan-Shan; Liu, Min; Li, Jiao-Yong; Zhang, Meng-Zhou; Guan, Da-Wei

    2015-08-15

    Muscle wound healing process is a typical inflammation-evoked event. The monoacylglycerol lipase (MAGL) inhibitor (4-nitrophenyl)4-[bis(1,3-benzodioxol -5-yl)-hydroxymethyl]piperidine-1-carboxylate (JZL184) has been previously reported to reduce inflammation in colitis and acute lung injury in mice, which provide a new strategy for primary care of skeletal muscle injury. We investigated the effect of JZL184 on inflammation in rat muscle contusion model, and found decreased neutrophil and macrophage infiltration and pro-inflammatory cytokine expression. With extension of post-traumatic interval, myofiber regeneration was significantly hindered with increased collagen types I and ІІІ mRNAfibroblast infiltration as well as promoted fibrosis. Furthermore, 1-(2,4-dichlorophenyl)-5-(4-iodophenyl)-4-methyl-N-morpholin-4-ylpyrazole-3-carboxamide (AM281, a selective cannabinoid CB1 receptor antagonist) and [6-iodo-2-methyl-1-(2-morpholin-4-ylethyl)indol-3-yl]-(4-methoxyphenyl)methanone (AM630, a selective cannabinoid CB2 receptor antagonist) treatment alleviated the anti-inflammatory effect of JZL184. Our findings demonstrate that JZL184 is able to inhibit the inflammatory response and interfere with contused muscle healing, in which the anti-inflammatory action may be mediated through cannabinoid CB1 and CB2 receptors.

  17. Aberrant LncRNA Expression Profile in a Contusion Spinal Cord Injury Mouse Model

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    Ya Ding

    2016-01-01

    Full Text Available Long noncoding RNAs (LncRNAs play a crucial role in cell growth, development, and various diseases related to the central nervous system. However, LncRNA differential expression profiles in spinal cord injury are yet to be reported. In this study, we profiled the expression pattern of LncRNAs using a microarray method in a contusion spinal cord injury (SCI mouse model. Compared with a spinal cord without injury, few changes in LncRNA expression levels were noted 1 day after injury. The differential changes in LncRNA expression peaked 1 week after SCI and subsequently declined until 3 weeks after injury. Quantitative real-time polymerase chain reaction (qRT-PCR was used to validate the reliability of the microarray, demonstrating that the results were reliable. Gene ontology (GO analysis indicated that differentially expressed mRNAs were involved in transport, cell adhesion, ion transport, and metabolic processes, among others. Kyoto Encyclopedia of Genes and Genomes (KEGG enrichment analysis showed that the neuroactive ligand-receptor interaction, the PI3K-Akt signaling pathway, and focal adhesions were potentially implicated in SCI pathology. We constructed a dynamic LncRNA-mRNA network containing 264 LncRNAs and 949 mRNAs to elucidate the interactions between the LncRNAs and mRNAs. Overall, the results from this study indicate for the first time that LncRNAs are differentially expressed in a contusion SCI mouse model.

  18. Creation of a contusion injury in rabbit skeletal muscle using a drop-mass technique

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    Margaret N. Deane

    2013-02-01

    Full Text Available This study reports our experience in developing a simple, minor injury. After reviewing the literature, a ‘drop-mass’ method was selected where a 201 g, elongated oval-shaped weight was dropped up to 15 times through a 1 m tube onto the left vastus lateralis of New Zealand white rabbits. To determine the extent of injury and degree of healing, biopsies were obtained six days after injury from the healing vastus lateralis of each animal. The tissue was fixed in formal saline, embedded in wax, cut and stained with haematoxylin and eosin (H&E and phosphotungstic acid haematoxylin (PTAH and examined by light microscopy (LM. The ‘optimal’ injury was created after seven drops, where quite severe, mild and moderately severe trauma was caused to muscle in the juxta-bone, mid and sub-dermal regions respectively. In each region, the muscle exhibited features of healing six days after injury. The ‘drop-mass’ technique appears to cause a contusion within a single muscle of at least three degrees of severity. This previously unreported observation is of particular importance to other researchers wishing to investigate contusion injury in other animal models.

  19. Systemic hypothermia improves histological and functional outcome after cervical spinal cord contusion in rats.

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    Lo, Thomas Pang; Cho, Kyoung-Suok; Garg, Maneesh Sen; Lynch, Michael Patrick; Marcillo, Alexander Eduardo; Koivisto, Denise Leigh; Stagg, Monica; Abril, Rosa Marie; Patel, Samik; Dietrich, W Dalton; Pearse, Damien Daniel

    2009-06-10

    Hypothermia has been employed during the past 30 years as a therapeutic modality for spinal cord injury (SCI) in animal models and in humans. With our newly developed rat cervical model of contusive SCI, we investigated the therapeutic efficacy of transient systemic hypothermia (beginning 5 minutes post-injury for 4 hours, 33 degrees C) with gradual rewarming (1 degrees C per hour) for the preservation of tissue and the prevention of injury-induced functional loss. A moderate cervical displacement SCI was performed in female Fischer rats, and behavior was assessed for 8 weeks. Histologically, the application of hypothermia after SCI resulted in significant increases in normal-appearing white matter (31% increase) and gray matter (38% increase) volumes, greater preservation (four-fold) of neurons immediately rostral and caudal to the injury epicenter, and enhanced sparing of axonal connections from retrogradely traced reticulospinal neurons (127% increase) compared with normothermic controls. Functionally, a faster rate of recovery in open field locomotor ability (BBB score, weeks 1-3) and improved forelimb strength, as measured by both weight-supported hanging (43% increase) and grip strength (25% increase), were obtained after hypothermia. The current study demonstrates that mild systemic hypothermia is effective for retarding tissue damage and reducing neurological deficits following a clinically relevant contusive cervical SCI.

  20. Morphological study of Schwann cells remyelination in contused spinal cord of rats

    Institute of Scientific and Technical Information of China (English)

    LI Yue; ZHANG Lu; ZHANG Jie-yuan; LIU Zheng; DUAN Zhao-xia; LI Bing-cang

    2013-01-01

    Objective:To study the role and effect of Schwann cells (SCs) remyelination in contused spinal cord.Methods:Green fluorescence protein expressing-SCs were transplanted into the epicenter,rostral and caudal tissues of the injury site at 1 week after the spinal cords were contused.At 6 weeks,the spinal cords were removed for cryosections,semithin sections and ultrathin sections,and then immunocytochemical staining of myelin basic protein (MBP),P0 protein (P0) and S 100 protein (S100) was carried out on the cryosections.Qualitative and semiquantitative analyses were performed on the cryosections and semithin sections.Ultrastructure ofmyelinated fibers was observed on the ultrathin sections under electron microscope.Results:Transplanted SCs and myelinated fibers immunocytochemically labeled by MBP,P0 as well as S100 distributed in whole injured area.The quantity of myelinated fibers labeled by the three myelin proteins showed no statistical difference,however,which was significantly larger than that of controls.On the semithin sections,the experimental group demonstrated more myelinated fibers in the injured area than the controls,but the fibers had smaller diameter and thinner myelin sheath under electron microscope.Conclusion:SCs can promote regeneration of injured nerve fibers and enhance remyelination,which may be histological basis of SCs-mediated functional repair of injured spinal cords.

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

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    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

  2. Interleukin-33 treatment reduces secondary injury and improves functional recovery after contusion spinal cord injury.

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    Pomeshchik, Yuriy; Kidin, Iurii; Korhonen, Paula; Savchenko, Ekaterina; Jaronen, Merja; Lehtonen, Sarka; Wojciechowski, Sara; Kanninen, Katja; Koistinaho, Jari; Malm, Tarja

    2015-02-01

    Interleukin-33 (IL-33) is a member of the interleukin-1 cytokine family and highly expressed in the naïve mouse brain and spinal cord. Despite the fact that IL-33 is known to be inducible by various inflammatory stimuli, its cellular localization in the central nervous system and role in pathological conditions is controversial. Administration of recombinant IL-33 has been shown to attenuate experimental autoimmune encephalomyelitis progression in one study, yet contradictory reports also exist. Here we investigated for the first time the pattern of IL-33 expression in the contused mouse spinal cord and demonstrated that after spinal cord injury (SCI) IL-33 was up-regulated and exhibited a nuclear localization predominantly in astrocytes. Importantly, we found that treatment with recombinant IL-33 alleviated secondary damage by significantly decreasing tissue loss, demyelination and astrogliosis in the contused mouse spinal cord, resulting in dramatically improved functional recovery. We identified both central and peripheral mechanisms of IL-33 action. In spinal cord, IL-33 treatment reduced the expression of pro-inflammatory tumor necrosis factor-alpha and promoted the activation of anti-inflammatory arginase-1 positive M2 microglia/macrophages, which chronically persisted in the injured spinal cord for up to at least 42 days after the treatment. In addition, IL-33 treatment showed a tendency towards reduced T-cell infiltration into the spinal cord. In the periphery, IL-33 treatment induced a shift towards the Th2 type cytokine profile and reduced the percentage and absolute number of cytotoxic, tumor necrosis factor-alpha expressing CD4+ cells in the spleen. Additionally, IL-33 treatment increased expression of T-regulatory cell marker FoxP3 and reduced expression of M1 marker iNOS in the spleen. Taken together, these results provide the first evidence that IL-33 administration is beneficial after CNS trauma. Treatment with IL33 may offer a novel therapeutic

  3. Comparative analysis of the protective effects of caffeic acid phenethyl ester (CAPE) on pulmonary contusion lung oxidative stress and serum copper and zinc levels in experimental rat model.

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    Sırmalı, Mehmet; Solak, Okan; Tezel, Cagatay; Sırmalı, Rana; Ginis, Zeynep; Atik, Dilek; Agackıran, Yetkin; Koylu, Halis; Delibas, Namık

    2013-01-01

    The aim of this study was to investigate the effects of caffeic acid phenethyl ester (CAPE) in the lungs by biochemical and histopathological analyses in an experimental isolated lung contusion model. Eighty-one male Sprague-Dawley rats were used. The animals were divided randomly into four groups: group 1 (n = 9) was defined as without contusion and without CAPE injection. Group 2 (n = 9) was defined as CAPE 10 μmol/kg injection without lung contusion. Group 3 (n = 36) was defined as contusion without CAPE-administrated group which consisted of four subgroups that were created according to analysis between days 0, 1, 2, and 3. Group 4 (n = 27) was defined as CAPE 10 μmol/kg administrated after contusion group divided into three subgroups according to analysis on days 1, 2, and 3. CAPE 10 μmol/kg was injected intraperitoneally 30 min after trauma and on days 1 and 2. Blood samples were obtained to measure catalase (CAT) and superoxide dismutase (SOD) activities and level of malondialdehyde (MDA) and for blood gas analysis. Trace elements such as zinc and copper were measured in serum. The lung tissue was also removed for histopathological examination. Isolated lung contusion increased serum and tissue SOD and CAT activities and MDA levels (p  0.05). CAPE also had a significant beneficial effect on blood gases (p  0.05). CAPE appears to be effective in protecting against severe oxidative stress and tissue damage caused by pulmonary contusion in an experimental setting. Therefore, we conclude that administration of CAPE may be used for a variety of conditions associated with pulmonary contusion. Clinical use of CAPE may have the advantage of prevention of pulmonary contusion.

  4. 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.

  5. Enhancement of bilateral cortical somatosensory evoked potentials to intact forelimb stimulation following thoracic contusion spinal cord injury in rats.

    Science.gov (United States)

    Bazley, Faith A; Maybhate, Anil; Tan, Chuen Seng; Thakor, Nitish V; Kerr, Candace; All, Angelo H

    2014-09-01

    The adult central nervous system is capable of significant reorganization and adaptation following neurotrauma. After a thoracic contusive spinal cord injury (SCI) neuropathways that innervate the cord below the epicenter of injury are damaged, with minimal prospects for functional recovery. In contrast, pathways above the site of injury remain intact and may undergo adaptive changes in response to injury. We used cortical somatosensory evoked potentials (SSEPs) to evaluate changes in intact forelimb pathways. Rats received a midline contusion SCI, unilateral contusion SCI, or laminectomy with no contusion at the T8 level and were monitored for 28 days post-injury. In the midline injury group, SSEPs recorded from the contralateral forelimb region of the primary somatosensory cortex were 59.7% (CI 34.7%, 84.8%; c(2) = 21.9; dof = 1; p = 2.9 ×10(-6)) greater than the laminectomy group; SSEPs from the ipsilateral somatosensory cortex were 47.6% (CI 18.3%, 77%; c(2) = 10.1; dof = 1; p = 0.001) greater. Activation of the ipsilateral somatosensory cortex was further supported by BOLD-fMRI, which showed increased oxygenation at the ipsilateral hemisphere at day seven post-injury. In the unilateral injury group, ipsilesional side was compared to the contralesional side. SSEPs on day 14 (148%; CI 111%, 185%) and day 21 (137%; CI 110%, 163%) for ipsilesional forelimb stimulation were significantly increased over baseline (100%). SSEPs recorded from the hindlimb sensory cortex upon ipsilesional stimulation were 33.9% (CI 14.3%, 53.4%; c(2) = 11.6; dof = 1; p = 0.0007) greater than contralesional stimulation. Therefore, these results demonstrate the ability of SSEPs to detect significant enhancements in the activation of forelimb sensory pathways following both midline and unilateral contusive SCI at T8. Reorganization of forelimb pathways may occur after thoracic SCI, which SSEPs can monitor to aid the development of future therapies.

  6. Detection of toluene in a body buried for years with a fatal cardiac contusion.

    Science.gov (United States)

    Tanaka, Toshiko; Sato, Hiroaki; Kasai, Kentaro

    2016-03-01

    This report aimed to present the postmortem finding of toluene in a homicide victim buried under the ground for six years. The bones of the skull and limbs were exposed, and the remainder of the subcutaneous tissues, brain and heart had formed into adipocere. There were numerous fractures in the skull and the anterior side of the ribs. A cardiac contusion extending into the cavity of the right ventricle was also observed. No other obvious injuries were identified on the body. The concentration of toluene in the bone marrow within the head of the humerus was 58.4 μg/g. The cause of death was suspected as heart rupture, possibly from a forceful impact or compression of the anterior chest under toluene intoxication. This report presents a rare case where toluene intake by a human was disclosed by autopsy even after several years of death. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Changes in calcium-binding protein expression in human cortical contusion tissue.

    Science.gov (United States)

    Buriticá, Efraín; Villamil, Liliana; Guzmán, Francisco; Escobar, Martha I; García-Cairasco, Norberto; Pimienta, Hernán J

    2009-12-01

    Traumatic brain injury (TBI) produces several cellular changes, such as gliosis, axonal and dendritic plasticity, and inhibition-excitation imbalance, as well as cell death, which can initiate epileptogenesis. It has been demonstrated that dysfunction of the inhibitory components of the cerebral cortex after injury may cause status epilepticus in experimental models; we proposed to analyze the response of cortical interneurons and astrocytes after TBI in humans. Twelve contusion samples were evaluated, identifying the expression of glial fibrillary acidic protein (GFAP) and calcium-binding proteins (CaBPs). The study was made in sectors with and without preserved cytoarchitecture evaluated with NeuN immunoreactivity (IR). In sectors with total loss of NeuN-IR the results showed a remarkable loss of CaBP-IR both in neuropil and somata. In sectors with conserved cytoarchitecture less drastic changes in CaBP-IR were detected. These changes include a decrease in the amount of parvalbumin (PV-IR) neurons in layer II, an increase of calbindin (CB-IR) neurons in layers III and V, and an increase in calretinin (CR-IR) neurons in layer II. We also observed glial fibrillary acidic protein immunoreactivity (GFAP-IR) in the white matter, in the gray-white matter transition, and around the sectors with NeuN-IR total loss. These findings may reflect dynamic activity as a consequence of the lesion that is associated with changes in the excitatory circuits of neighboring hyperactivated glutamatergic neurons, possibly due to the primary impact, or secondary events such as hypoxia-ischemia. Temporal evolution of these changes may be the substrate linking severe cortical contusion and the resulting epileptogenic activity observed in some patients.

  8. Role of pulmonary artery reactivity and nitric oxide in injury and inflammation following lung contusion.

    Science.gov (United States)

    Lakshminrusimha, Satyan; Suresh, Madathilparambil V; Knight, Paul R; Gugino, Sylvia F; Davidson, Bruce A; Helinski, Jadwiga D; Nielsen, Lori C; Russell, James A; Yu, Bi; Zeng, Lixia; Pennathur, Subramaniam; Raghavendran, Krishnan

    2013-03-01

    The mechanisms contributing to hypoxia in lung contusion (LC) remain unclear and not temporally associated with the peak onset of acute inflammation. We investigated the role of oxidative stress in alteration of pulmonary arterial (PA) reactivity following LC. In addition, the role of antioxidants in reversing this process was examined. PaO2 and PA reactivity were measured in rats subjected to bilateral LC. Rings were pretreated with a nitric oxide synthase (NOS) inhibitor, L-nitro arginine (10(-3) M), or PEG-superoxide dismutase (SOD) and PEG-catalase (CAT), or both (L-nitro arginine + SOD/CAT). Rings were constricted with norepinephrine and relaxed with an NOS agonist (A23187) or NO donor (SNAP [S-nitrosyl amino penicillamine]). Immunochemical and mass spectrometric quantification for nitrotyrosine was performed. Rats were hypoxemic at 4 h after contusion compared with controls, but recovered by 24 h (PaO(2)/FIO(2) ratio: baseline, 443 ± 28; 4 h, 288 ± 46; and 24 h, 417 ± 23). Pulmonary arterial constriction to NOS inhibition and relaxation to A23187 were impaired 4 h after LC. Pulmonary arterial relaxation to SNAP was decreased at 4 and 24 h after LC. These alterations in PA reactivity were reversed by SOD/CAT pretreatment. SOD1 and 2 mRNA were upregulated, and soluble guanylyl cyclase mRNA was downregulated 24 h after LC. Immunohistochemistry and mass spectrometry revealed that levels of 3-nitrotyrosine were increased markedly at 4 h following LC consistent with superoxide generation and formation of peroxynitrite. Collectively, these data suggest that consumption of NO due to excess superoxide resulting in peroxynitrite formation leads to diminished vascular reactivity following LC.

  9. 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

    OpenAIRE

    Benincasa,Cristian Chassot

    2007-01-01

    Introdução: a contusão miocárdica é causada usualmente por trauma torácico fechado, principalmente em pacientes com história de acidente de carro ou moto. Os pacientes com manifestações clínicas graves devem manejados com intubação, reposição volêmica, vasopressor e inotrópicos. O levosimendan é uma nova droga com ação inodilatadora, que age sensibilizando os canais de cálcio. O objetivo deste relato é documentar o tratamento de um caso de choque cardiogênico secundário a contusão miocárdica,...

  10. Association of dynamic changes in serum cytokine levels with the severity of injury in patients suffering from closed chest traumas complicated with pulmonary contusions

    OpenAIRE

    2011-01-01

    This study aimed to examine the dynamic changes in the serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 in patients suffering from closed chest injuries and concomitant pulmonary contusions and their correlation with the Thoracic Trauma Severity Score (TTS) and Injury Severity Score (ISS). Patients with multiple traumas with an ISS ≥16 (n=41) were evaluated in the study. Patients included 21 individuals with trauma complicated by pulmonary contusion and 20 patients ...

  11. A finite element-based injury metric for pulmonary contusion: investigation of candidate metrics through correlation with computed tomography.

    Science.gov (United States)

    Gayzik, F Scott; Hoth, J Jason; Daly, Melissa; Meredith, J Wayne; Stitzel, Joel D

    2007-10-01

    Pulmonary contusion (PC) is the most common thoracic soft tissue injury following non-penetrating blunt trauma and has been associated with mortality rates as high as 25%. This study is part of an ongoing effort to develop a finite element based injury criteria for PC. The aims of this study are two fold. The first is to investigate the use of computed tomography (CT) to quantify the volume of pathologic lung tissue in a prospective study of PC. The second is to use a finite element model (FEM) of the lung to investigate several mathematical predictors of contusion to determine the injury metric that best matches the spatial distribution of contusion obtained from the CT analysis. PC is induced in-situ utilizing male Sprague Dawley rats (n = 24) through direct impact to the right lung at 5.0 ms(-1). Force vs. deflection data are collected and used for model validation and optimization. CT scans are taken at 24 hours, 48 hours, 1 week, and 1 month post contusion. A numerical simulation is performed using an FEM of the rat lung and surrounding structures. Injury predictors investigated include maximum first principal strain, maximum shear strain, triaxial mean strain, octahedral shear stress, and maximum shear stress. Strain rate and the product of strain and strain rate are evaluated for all listed strains. At each post-impact time point, the volume of contused lung is used to determine the specific elements representing pathologic lung. Through this method, a threshold is determined for all listed metrics. The spatial distribution of the elements exceeding this threshold is compared to the spatial distribution of high-radiopacity lung tissue in the CT through a three dimensional registration technique to determine the predictor with the best correlation to the outcome. Impacts resulted in a mean energy input to the lung of 8.74 +/- 2.5 mJ. Segmentation of the imaging data yielded a mean unilateral high-radiopacity tissue estimate of 14.5% by volume at 24 hours with

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

    Directory of Open Access Journals (Sweden)

    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.

  13. The fibrotic role of phosphatidylinositol-3-kinase/Akt pathway in injured skeletal muscle after acute contusion.

    Science.gov (United States)

    Li, H-Y; Zhang, Q-G; Chen, J-W; Chen, S-Q; Chen, S-Y

    2013-09-01

    Transforming growth factor β (TGF-β) is a multifunctional cytokine with fibrogenic properties. Previous studies demonstrated that Phosphatidylinositol 3-Kinase (PI3K)/Akt/ mammalian target of Ramycin (mTOR), a non-Smad TGF-β pathway, plays an important role in the fibrotic pathogenesis of different organs such as the lung, kidney, skin and liver. However, the role of PI3k-Akt pathway in fibrosis in injured skeletal muscle is still unclear. In this study, we determined the fibrotic role of PI3K-Akt pathway in injured skeletal muscle. We established a mouse model for acute muscle contusion. Western blotting analysis showed that TGF-β, phosphorylated Akt and phosphorylated mTOR were increased in muscles after acute contusion, which indicated that the PI3K-Akt- mTOR pathway was activated in skeletal muscle after acute contusion. The pathway was inhibited by a PI3K inhibitor, LY294002. Moreover, the expression of fibrosis markers vimentin, α SMA and collagen I and the area of scar decreased in injured skeletal muscle after PI3K pathway was blocked. The muscle function improved in terms of both fast-twitch and tetanic strength after PI3K/Akt pathway was inhibited in injured skeletal muscle. In conclusion, activation of PI3K-Akt-mTOR pathway might promote collagen production and scar formation in the acute contused skeletal muscle. Blocking of PI3K-Akt-mTOR pathway could improve the function of injured skeletal muscle.

  14. Differential Histopathological and Behavioral Outcomes Eight Weeks after Rat Spinal Cord Injury by Contusion, Dislocation, and Distraction Mechanisms

    Science.gov (United States)

    Chen, Kinon; Liu, Jie; Assinck, Peggy; Bhatnagar, Tim; Streijger, Femke; Zhu, Qingan; Dvorak, Marcel F.; Kwon, Brian K.; Tetzlaff, Wolfram

    2016-01-01

    Abstract The objective of this study was to compare the long-term histological and behavioral outcomes after spinal cord injury (SCI) induced by one of three distinct biomechanical mechanisms: dislocation, contusion, and distraction. Thirty male Sprague-Dawley rats were randomized to incur a traumatic cervical SCI by one of these three clinically relevant mechanisms. The injured cervical spines were surgically stabilized, and motor function was assessed for the following 8 weeks. The spinal cords were then harvested for histologic analysis. Quantification of white matter sparing using Luxol fast blue staining revealed that dislocation injury caused the greatest overall loss of white matter, both laterally and along the rostrocaudal axis of the injured cord. Distraction caused enlarged extracellular spaces and structural alteration in the white matter but spared the most myelinated axons overall. Contusion caused the most severe loss of myelinated axons in the dorsal white matter. Immunohistochemistry for the neuronal marker NeuN combined with Fluoro Nissl revealed that the dislocation mechanism resulted in the greatest neuronal cell losses in both the ventral and dorsal horns. After the distraction injury mechanism, animals displayed no recovery of grip strength over time, in contrast to the animals subjected to contusion or dislocation injuries. After the dislocation injury mechanism, animals displayed no improvement in the grooming test, in contrast to the animals subjected to contusion or distraction injuries. These data indicate that different SCI mechanisms result in distinct patterns of histopathology and behavioral recovery. Understanding this heterogeneity may be important for the future development of therapeutic interventions that target specific neuropathology after SCI. PMID:26671448

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

    OpenAIRE

    Keirstead Hans S; Nistor Gabriel; Radojicic Milan

    2007-01-01

    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 In...

  16. Diagnostic Accuracy of Ultrasonography and Radiography in Detection of Pulmonary Contusion; a Systematic Review and Meta-Analysis

    OpenAIRE

    HOSSEINI, Mostafa; Ghelichkhani, Parisa; Baikpour, Masoud; Tafakhori, Abbas; Asady, Hadi; Haji Ghanbari, Mohammad Javad; Yousefifard, Mahmoud; Safari, Saeed

    2015-01-01

    Introduction: Ultrasonography is currently being used as one of the diagnostic modalities in various medical emergencies for screening of trauma patients. The diagnostic value of this modality in detection of traumatic chest injuries has been evaluated by several studies but its diagnostic accuracy in diagnosis of pulmonary contusion is a matter of discussion. Therefore, the present study aimed to determine the diagnostic accuracy of ultrasonography and radiography in detection of pulmonary c...

  17. Treatment experience on 72 cases with pulmonary contusion%肺挫伤72例治疗体会

    Institute of Scientific and Technical Information of China (English)

    杨秀华; 张武坊; 龙建军; 胡刚

    2016-01-01

    Objective:To investigate the effective treatment on pulmonary contusion,in order to improve the treatment effect. Methods:The clinical data of 120 cases with pulmonary contusion were analyzed retrospectively.Results:Among those 120 cases with systemic treatment,69 cases were cured(95.83% ),3 cases were dead(4.17% ),and the treatment effect was satisfactory. Conclusion:Pulmonary contusion always combined with other injury,so the condition of those patients were seriously.Early diagnosis and aggressive treatment on combined injury was the key to improve the treatment effect.%目的:探讨肺挫伤有效治疗方法,提高肺挫伤治疗效果。方法:回顾性分析120例肺挫伤临床资料。结果:120例经过系统治疗,治愈69例(95.83%),死亡3例(4.17%),治疗效果满意。结论:肺挫伤往往合并其他合并伤,病情严重,早期诊断、积极处理合并伤是提高治疗效果的关键。

  18. Combined transplantation of GDAsBMP and hr-decorin in spinal cord contusion repair****○

    Institute of Scientific and Technical Information of China (English)

    Liang Wu; Jianjun Li; Liang Chen; Hong Zhang; Li Yuan; Stephen JA Davies

    2013-01-01

    Fol owing spinal cord injury, astrocyte proliferation and scar formation are the main factors inhibiting the regeneration and growth of spinal cord axons. Recombinant decorin suppresses inflammatory reactions, inhibits glial scar formation, and promotes axonal growth. Rat models of T8 spinal cord contusion were created with the NYU impactor and these models were subjected to combined transplantation of bone morphogenetic protein-4-induced glial-restricted precursor-derived astro-cytes and human recombinant decorin transplantation. At 28 days after spinal cord contusion, dou-ble-immunofluorescent histochemistry revealed that combined transplantation inhibited the early in-flammatory response in injured rats. Furthermore, brain-derived neurotrophic factor, which was se-creted by transplanted cel s, protected injured axons. The combined transplantation promoted ax-onal regeneration and growth of injured motor and sensory neurons by inhibiting astrocyte prolifer-ation and glial scar formation, with astrocytes forming a linear arrangement in the contused spinal cord, thus providing axonal regeneration channels.

  19. 肺挫裂伤的影像表现%The imaging manifestation of pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    薛文

    2015-01-01

    ObjectiveStudy the pathology and the imaging characteristics of pulmonary contusion, so as to improve the level of understanding of its.Methods Were retrospectively analyzed the clinical data of 36 patients with pulmonary contusion, X-ray chest radiograph, CT showed situation, to explore its pathological basis and imaging findings.ResultsTexture change in 18 cases, pulmonary shadow 14 cases of small spots sheets, cloud-like and ground glass shadow 13 cases, 7 cases of big shape high density shade, pulmonary cavity shadow in 2 cases, pulmonary cyst fluid gas and 8 cases of hematoma shadows.Conclusions Imaging can display the lesions of the basic form and distribution, provide more reliable basis for clinical treatment.%目的:探讨肺挫裂伤的病理及影像学特点,从而提高对其的认识水平。方法:回顾性分析36例肺挫裂伤患者的临床资料、X线胸片、CT的显示情况,探讨其形成病理基础和影像学表现。结果:表现为肺纹理改变、磨玻璃状、斑片状模糊影、肺空腔、液气囊腔及肺血肿等,其中肺纹理改变18例,小斑点片状影14例,云雾状及磨玻璃状阴影13例,大片状高密度影7例,肺空腔影2例,肺液气囊肿及血肿影8例,另外还发现气胸、液(血)气胸、纵隔气肿、皮下气肿及肋骨、锁骨骨折等。结论:肺挫裂伤具有典型影像表现,影像检查可显示其病变的基本形态和分布,为临床治疗提供更多更可靠的依据。认识掌握肺挫裂伤的各种影像学表现,是早期临床治疗的基础。

  20. Efficacy of nerve growth factor on the treatment of optic nerve contusion Evaluation with visual evoked potential

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Pattern- visual evoked potential (PVEP) can reflect the functional status of retinal ganglial cells (RGC) and visual cortex, and is an objective examination for visual pathway function. It is a unique method for objectively examining the optic nerve function of optic ganglion cells.OBJECTIVE: To observe the effects of nerve growth factor (NGF) on PVEF in the treatment of optic nerve contusion, evaluate the clinical efficacy of NGF, and make an efficacy comparison with vitamin B12.DESIGN: A randomly grouping, controlled observation.SETTING: Department of Ophthalmology, Tangshan Gongren Hospital Affiliated to Hebei Medical University.PARTICIPANTS: Forty patients with optic nerve contusion caused by eye trauma, who received the treatment in the Tangshan Worker Hospital Affiliated to Hebei Medical University between January 2006 and June 2007, were recruited in this study. The involved 40 patients, including 34 males and 6 females,were aged 14 - 59 years. They were confirmed to have optic nerve contusion by ophthalmologic consultation combined with history of disease and orbital CT examination. Informed consents of treatments and detected items were obtained from all the patients. The patients were randomly divided into 2 groups with 20 in each:NGF group and vitamin B12 group.METHODS: Conservative treatment was used in the two groups. In addition, patients in the NGF group were intramuscularly injected with NGF solution 18 μg/time, once a day. Those in the vitamin B12 group were injected by the same method with common vitamin B12 of 500 μg combined with vitamin B1 of 100 mg, once a day.MAIN OUTCOME MEASURES: PVEP examination was conducted in all the patients before, one and two weeks after treatment, and latency and amplitude at P100 were detected.RESULTS: Forty patients with optic nerve contusion participated in the final analysis. Before treatment,significant differences in the latency and amplitude at P100 were not found in patients between two groups

  1. Diagnostic accuracy of evoked potentials for functional impairment after contusive spinal cord injury in adult rats.

    Science.gov (United States)

    Thirumala, Parthasarathy; Zhou, James; Krishnan, Rohan; Manem, Nihita; Umredkar, Shreya; Hamilton, D K; Balzer, Jeffrey R; Oudega, Martin

    2016-03-01

    Iatrogenic spinal cord injury (SCI) is a cause of potentially debilitating post-operative neurologic complications. Currently, intra-operative neurophysiological monitoring (IONM) via somatosensory evoked potentials and motor-evoked potentials is used to detect and prevent impending SCI. However, no empirically validated interventions exist to halt the progression of iatrogenic SCI once it is detected. This is in part due to the lack of a suitable translational model that mimics the circumstances surrounding iatrogenic SCI detected via IONM. Here, we evaluate a model of simulated contusive iatrogenic SCI detected via IONM in adult female Sprague-Dawley rats. We show that transient losses of somatosensory evoked potentials responses are 88.24% sensitive (95% confidence interval [CI] 63.53-98.20) and 80% specific (95% CI 51.91-95.43) for significant functional impairment following simulated iatrogenic SCI. Similarly, we show that transient losses in motor-evoked potentials responses are 70.83% sensitive (95% CI 48.91-87.33) and 100% specific (95% CI 62.91-100.00) for significant functional impairment following simulated iatrogenic SCI. These results indicate that our model is a suitable replica of the circumstances surrounding clinical iatrogenic SCI.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. A Unilateral Cervical Spinal Cord Contusion Injury Model in Non-Human Primates (Macaca mulatta).

    Science.gov (United States)

    Salegio, Ernesto A; Bresnahan, Jacqueline C; Sparrey, Carolyn J; Camisa, William; Fischer, Jason; Leasure, Jeremi; Buckley, Jennifer; Nout-Lomas, Yvette S; Rosenzweig, Ephron S; Moseanko, Rod; Strand, Sarah; Hawbecker, Stephanie; Lemoy, Marie-Josee; Haefeli, Jenny; Ma, Xiaokui; Nielson, Jessica L; Edgerton, V R; Ferguson, Adam R; Tuszynski, Mark H; Beattie, Michael S

    2016-03-01

    The development of a non-human primate (NHP) model of spinal cord injury (SCI) based on mechanical and computational modeling is described. We scaled up from a rodent model to a larger primate model using a highly controllable, friction-free, electronically-driven actuator to generate unilateral C6-C7 spinal cord injuries. Graded contusion lesions with varying degrees of functional recovery, depending upon pre-set impact parameters, were produced in nine NHPs. Protocols and pre-operative magnetic resonance imaging (MRI) were used to optimize the predictability of outcomes by matching impact protocols to the size of each animal's spinal canal, cord, and cerebrospinal fluid space. Post-operative MRI confirmed lesion placement and provided information on lesion volume and spread for comparison with histological measures. We evaluated the relationships between impact parameters, lesion measures, and behavioral outcomes, and confirmed that these relationships were consistent with our previous studies in the rat. In addition to providing multiple univariate outcome measures, we also developed an integrated outcome metric describing the multivariate cervical SCI syndrome. Impacts at the higher ranges of peak force produced highly lateralized and enduring deficits in multiple measures of forelimb and hand function, while lower energy impacts produced early weakness followed by substantial recovery but enduring deficits in fine digital control (e.g., pincer grasp). This model provides a clinically relevant system in which to evaluate the safety and, potentially, the efficacy of candidate translational therapies.

  4. Localization of Fibrinogen in the Vasculo-Astrocyte Interface after Cortical Contusion Injury in Mice

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    Nino Muradashvili

    2017-07-01

    Full Text Available Besides causing neuronal damage, traumatic brain injury (TBI is involved in memory reduction, which can be a result of alterations in vasculo-neuronal interactions. Inflammation following TBI is involved in elevation of blood content of fibrinogen (Fg, which is known to enhance cerebrovascular permeability, and thus, enhance its deposition in extravascular space. However, the localization of Fg in the extravascular space and its possible interaction with nonvascular cells are not clear. The localization of Fg deposition in the extravascular space was defined in brain samples of mice after cortical contusion injury (CCI and sham-operation (control using immunohistochemistry and laser-scanning confocal microscopy. Memory changes were assessed with new object recognition and Y-maze tests. Data showed a greater deposition of Fg in the vascular and astrocyte endfeet interface in mice with CCI than in control animals. This effect was accompanied by enhanced neuronal degeneration and reduction in short-term memory in mice with CCI. Thus, our results suggest that CCI induces increased deposition of Fg in the vasculo-astrocyte interface, and is accompanied by neuronal degeneration, which may result in reduction of short-term memory.

  5. N-Acetylcysteine counteracts oxidative stress and protects alveolar epithelial cells from lung contusion-induced apoptosis in rats with blunt chest trauma.

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    Topcu-Tarladacalisir, Yeter; Tarladacalisir, Taner; Sapmaz-Metin, Melike; Karamustafaoglu, Altemur; Uz, Yesim Hulya; Akpolat, Meryem; Cerkezkayabekir, Aysegul; Turan, Fatma Nesrin

    2014-08-01

    The aim of this study was to investigate the protective effects of N-acetylcysteine (NAC) on peroxidative and apoptotic changes in the contused lungs of rats following blunt chest trauma. The rats were randomly divided into three groups: control, contusion, and contusion + NAC. All the rats, apart from those in the control group, performed moderate lung contusion. A daily intramuscular NAC injection (150 mg/kg) was given immediately following the blunt chest trauma and was continued for two additional days following cessation of the trauma. Samples of lung tissue were taken in order to evaluate the tissue malondialdehyde (MDA) level, histopathology, and epithelial cell apoptosis using terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay and active caspase-3 immunostaining. In addition, we immunohistochemically evaluated the expression of surfactant protein D (SP-D) in the lung tissue. The blunt chest trauma-induced lung contusion resulted in severe histopathological injury, as well as an increase in the MDA level and in the number of cells identified on TUNEL assay together with active caspase-3 positive epithelial cells, but a decrease in the number of SP-D positive alveolar type 2 (AT-2) cells. NAC treatment effectively attenuated histopathologic, peroxidative, and apoptotic changes, as well as reducing alterations in SP-D expression in the lung tissue. These findings indicate that the beneficial effects of NAC administrated following blunt chest trauma is related to the regulation of oxidative stress and apoptosis.

  6. Does urinary trypsin inhibitor have a role in acute lung injury induced by pulmonary contusion: a basic research in a model of rats.

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    Wang, Shaohua; Wang, Jin; Chen, Xi; Ruan, Zheng; Zheng, Jin; Zhang, Jie

    2014-01-01

    We evaluate the efficacy of urinary trypsin inhibitor (UTI) on inflammation, oxidative stress, hypoxemia, and diseased lesion in a rat model of acute lung injury induced by blunt trauma. Rats were allocated to 4 groups. One group served as normal control. The other 3 groups had a moderate pulmonary contusion. Except for 1 sham group administrated saline, 1 group was administrated low-dose UTI (20,000 U/kg), and another group was administrated high-dose UTI (50,000 U/kg). Twelve hours after contusion, neutrophil counting in bronchoalveolar lavage fluid (BALF) was performed and tumor necrosis factor α level and albumin level in BALF was tested. Lung tissue malondialdehyde levels, superoxide dismutase, and catalase activity was investigated, and blood gas analysis and contusion volume quantification using 3-dimensional computed tomography were performed. High-dose UTI significantly decreased neutrophil count and tumor necrosis factor α level in BALF (Pcontusion volume by UTI (P>0.05). UTI has a dose-dependent trend to ameliorate inflammatory and oxygen stress in pulmonary contusion-induced acute lung injury. However, the effect on hypoxemia and contusion lesion and the best administration regime should be investigated in future study.

  7. The analysis of application of MRI in the knee joint bone contusion%MRI在膝关节骨挫伤中的应用分析

    Institute of Scientific and Technical Information of China (English)

    刘海忠

    2015-01-01

    MRI可以对膝关节的骨挫伤的病理变化予以揭示,并且能够对关节周围的韧带以及软组织的损伤情况进行准确的判断。本文通过对膝关节骨挫伤的病理基础与MRI信号特点、MRI诊断骨挫伤的价值与临床意义、骨挫伤的MRI鉴别诊断等进行了系统的阐述,对MRI在膝关节骨挫伤中的应用进行分析。%MRI can reveal to the pathological changes of the bone contusion of knee joint. And around the joints of the ligaments and soft tissue injury of accurate judgment. This article through to the pathogenesis of knee joint bone contusion of MRI signal characteristics, and MRI diagnostic value and clinical significance of bone contusion, bone contusion of MRI diagnosis of the system, the application of MRI in the knee joint bone contusion were analyzed.

  8. 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

  9. Surfactant dysfunction in lung contusion with and without superimposed gastric aspiration in a rat model.

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    Raghavendran, Krishnan; Davidson, Bruce A; Knight, Paul R; Wang, Zhengdong; Helinski, Jadwiga; Chess, Patricia R; Notter, Robert H

    2008-11-01

    This study investigates surfactant dysfunction in rats with lung contusion (LC) induced by blunt chest trauma. Rats at 24 h postcontusion had a decreased percent content of large surfactant aggregates in cell-free bronchoalveolar lavage (BAL) and altered large-aggregate composition with decreased phosphatidylcholine (PC), increased lyso-PC, and increased protein compared with uninjured controls. The surface activity of large aggregates on a pulsating bubble surfactometer was also severely impaired at 24 h postcontusion. Decreases in large surfactant aggregate content and surface activity were improved, but still apparent, at 48 and 72 h postcontusion compared with uninjured control rats and returned to normal by 96 h postcontusion. The functional importance of surfactant abnormalities in LC injury was documented in pilot studies showing that exogenous surfactant replacement at 24 h postcontusion improved inflation/deflation lung volumes. Additional experiments investigated a clinically relevant combination of LC plus gastric aspiration (combined acid and small gastric food particles) and found reductions in large surfactant aggregates in BAL similar to those for LC. However, rats given LC + combined acid and small gastric food particles versus LC had more severe surfactant dysfunction based on decreases in surface activity and alterations in large aggregate composition. Combined data for all animal groups had strong statistical correlations between surfactant dysfunction (increased minimum surface tension, decreased large aggregates in BAL, decreased aggregate PC, and increased aggregate lyso-PC) and the severity of inflammatory lung injury (increased total protein, albumin, protein/phospholipid ratio, neutrophils, and erythrocytes in BAL plus increased whole lung myeloperoxidase activity). These results show that surfactant dysfunction is important in the pathophysiology of LC with or without concurrent gastric aspiration and provides a rationale for surfactant

  10. Effects of Massage on Satellite Cells of Acute Contusive Skeletal Muscles

    Institute of Scientific and Technical Information of China (English)

    胡军; 张喜林; 严隽陶

    2007-01-01

    Objective: To study the mechanism of Tuina in the treatment of skeletal muscle injury. Methods: Rabbits were heavily beaten at gastrocnemius muscle to make acute contusion model and then treated respectively by early Tuina and routine Tuina. The number of satellite cells of skeletal muscles was observed. Results: The number of the satellite cells continued to grow in both groups, and it began to increase significantly 3-5 days after Tuina treatment. Early Tuina treatment produces larger number of satellite cells than routine Tuina treatment.Conclusion: Early Tuina treatment is helpful to the marked recovery of skeletal muscles by increasing the number of satellite cell.%目的:探讨推拿治疗骨骼肌损伤的机理.方法:以重物打击方式造成腓肠肌急性挫伤模型,施以早期推拿治疗和常规推拿治疗,观察骨骼肌卫星细胞数量变化.结果:各组卫星细胞数量均呈持续上升趋势,常规治疗组和早期手法组的卫星细胞数量在3~5 d时就开始有大幅度上升.早期手法组卫星细胞数量多于常规治疗组.结论:早期手法对卫星细胞数增加作用明显有助于骨骼肌功能恢复.

  11. Role of macrophage chemoattractant protein-1 in acute inflammation after lung contusion.

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    Suresh, Madathilparambil V; Yu, Bi; Machado-Aranda, David; Bender, Matthew D; Ochoa-Frongia, Laura; Helinski, Jadwiga D; Davidson, Bruce A; Knight, Paul R; Hogaboam, Cory M; Moore, Bethany B; Raghavendran, Krishnan

    2012-06-01

    Lung contusion (LC), commonly observed in patients with thoracic trauma is a leading risk factor for development of acute lung injury/acute respiratory distress syndrome. Previously, we have shown that CC chemokine ligand (CCL)-2, a monotactic chemokine abundant in the lungs, is significantly elevated in LC. This study investigated the nature of protection afforded by CCL-2 in acute lung injury/acute respiratory distress syndrome during LC, using rats and CC chemokine receptor (CCR) 2 knockout (CCR2(-/-)) mice. Rats injected with a polyclonal antibody to CCL-2 showed higher levels of albumin and IL-6 in the bronchoalveolar lavage and myeloperoxidase in the lung tissue after LC. Closed-chest bilateral LC demonstrated CCL-2 localization in alveolar macrophages (AMs) and epithelial cells. Subsequent experiments performed using a murine model of LC showed that the extent of injury, assessed by pulmonary compliance and albumin levels in the bronchoalveolar lavage, was higher in the CCR2(-/-) mice when compared with the wild-type (WT) mice. We also found increased release of IL-1β, IL-6, macrophage inflammatory protein-1, and keratinocyte chemoattractant, lower recruitment of AMs, and higher neutrophil infiltration and phagocytic activity in CCR2(-/-) mice at 24 hours. However, impaired phagocytic activity was observed at 48 hours compared with the WT. Production of CCL-2 and macrophage chemoattractant protein-5 was increased in the absence of CCR2, thus suggesting a negative feedback mechanism of regulation. Isolated AMs in the CCR2(-/-) mice showed a predominant M1 phenotype compared with the predominant M2 phenotype in WT mice. Taken together, the above results show that CCL-2 is functionally important in the down-modulation of injury and inflammation in LC.

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

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    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

  13. Effects of Topical Icing on Inflammation, Angiogenesis, Revascularization, and Myofiber Regeneration in Skeletal Muscle Following Contusion Injury

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    Singh, Daniel P.; Barani Lonbani, Zohreh; Woodruff, Maria A.; Parker, Tony J.; Steck, Roland; Peake, Jonathan M.

    2017-01-01

    Contusion injuries in skeletal muscle commonly occur in contact sport and vehicular and industrial workplace accidents. Icing has traditionally been used to treat such injuries under the premise that it alleviates pain, reduces tissue metabolism, and modifies vascular responses to decrease swelling. Previous research has examined the effects of icing on inflammation and microcirculatory dynamics following muscle injury. However, whether icing influences angiogenesis, collateral vessel growth, or myofiber regeneration remains unknown. We compared the effects of icing vs. a sham treatment on the presence of neutrophils and macrophages; expression of CD34, von Willebrands factor (vWF), vascular endothelial growth factor (VEGF), and nestin; vessel volume; capillary density; and myofiber regeneration in skeletal after muscle contusion injury in rats. Muscle tissue was collected 1, 3, 7, and 28 d after injury. Compared with uninjured rats, muscles in rats that sustained the contusion injury exhibited major necrosis, inflammation, and increased expression of CD34, vWF, VEGF, and nestin. Compared with the sham treatment, icing attenuated and/or delayed neutrophil and macrophage infiltration; the expression of vWF, VEGF, and nestin; and the change in vessel volume within muscle in the first 7 d after injury (P < 0.05). By contrast, icing did not influence capillary density in muscle 28 d after injury (P = 0.59). The percentage of immature myofibers relative to the total number of fibers was greater in the icing group than in the sham group 28 d after injury (P = 0.026), but myofiber cross-sectional area did not differ between groups after 7 d (P = 0.35) and 28 d (P = 0.30). In conclusion, although icing disrupted inflammation and some aspects of angiogenesis/revascularization, these effects did not result in substantial differences in capillary density or muscle growth. PMID:28326040

  14. Skeletal muscle adaptations following spinal cord contusion injury in rat and the relationship to locomotor function: a time course study.

    Science.gov (United States)

    Hutchinson, K J; Linderman, J K; Basso, D M

    2001-10-01

    Experimental spinal cord injury (SCI) via contusion of moderate severity results in residual locomotor deficits, including a lack of coordination and trunk stability. Given that muscle contractile properties and fiber composition adapt to reduced neural input and/or weight bearing, contusion-induced locomotor deficits may reflect changes in hindlimb skeletal muscle. Therefore, we examined muscle adaptations during early (1 week), intermediate (3 week), and late (10 week) stages of motor recovery after moderate SCI. Forty-two Sprague Dawley rats underwent SCI via 1.1mm cord displacement with the OSU impact device or served as age and weight-matched or laminectomy controls. Subsets of rats had soleus (SOL) in vitro physiological testing or SOL and extensor digitorum longus (EDL) myosin heavy chain (MHC) fiber type analysis. At 1 week post-SCI during paralysis/paresis, a significant decrease in wet weight occurred in the plantaris, medial/lateral gastrocnemius (MG/LG), tibialis anterior, and SOL. Changes in contractile properties of the SOL did not accompany muscle wet weight changes. By 3 weeks, the loss of weight-bearing activity early after SCI induced significant decreases in SOL peak twitch and peak tetanic tension as well as significantly greater IIx MHC expression in the EDL. By 10 weeks post-SCI, after several weeks of weight supported stepping, muscle wet weight, contractile properties and MHC composition returned to baseline levels except for MG/LG atrophy. Thus, muscle plasticity appears to be extremely sensitive to locomotor deficits and their resolution after moderate spinal cord contusion.

  15. Human embryonic stem cell-derived oligodendrocyte progenitors aid in functional recovery of sensory pathways following contusive spinal cord injury.

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    Angelo H All

    Full Text Available BACKGROUND: Transplantations of human stem cell derivatives have been widely investigated in rodent models for the potential restoration of function of neural pathways after spinal cord injury (SCI. Studies have already demonstrated cells survival following transplantation in SCI. We sought to evaluate survival and potential therapeutic effects of transplanted human embryonic stem (hES cell-derived oligodendrocyte progenitor cells (OPCs in a contusive injury in rats. Bioluminescence imaging was utilized to verify survivability of cells up to 4 weeks, and somatosensory evoked potential (SSEPs were recorded at the cortex to monitor function of sensory pathways throughout the 6-week recovery period. PRINCIPAL FINDINGS: hES cells were transduced with the firefly luciferase gene and differentiated into OPCs. OPCs were transplanted into the lesion epicenter of rat spinal cords 2 hours after inducing a moderate contusive SCI. The hES-treatment group showed improved SSEPs, including increased amplitude and decreased latencies, compared to the control group. The bioluminescence of transplanted OPCs decreased by 97% in the injured spinal cord compared to only 80% when injected into an uninjured spinal cord. Bioluminescence increased in both experimental groups such that by week 3, no statistical difference was detected, signifying that the cells survived and proliferated independent of injury. Post-mortem histology of the spinal cords showed integration of human cells expressing mature oligodendrocyte markers and myelin basic protein without the expression of markers for astrocytes (GFAP or pluripotent cells (OCT4. CONCLUSIONS: hES-derived OPCs transplanted 2 hours after contusive SCI survive and differentiate into OLs that produce MBP. Treated rats demonstrated functional improvements in SSEP amplitudes and latencies compared to controls as early as 1 week post-injury. Finally, the hostile injury microenvironment at 2 hours post-injury initially caused

  16. 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.

  17. Effects of epidural hypothermic saline infusion on locomotor outcome and tissue preservation after moderate thoracic spinal cord contusion in rats.

    Science.gov (United States)

    Casas, Carlos E; Herrera, Loren P; Prusmack, Chad; Ruenes, Gladys; Marcillo, Alexander; Guest, James D

    2005-03-01

    Regionally delivered hypothermia has advantages over systemic hypothermia for clinical application following spinal cord injury (SCI). The effects of local hypothermia on tissue sparing, neuronal preservation, and locomotor outcome were studied in a moderate thoracic spinal cord contusion model. Rats were randomized to four treatment groups and data were collected and analyzed in a blinded fashion. Chilled saline was perfused into the epidural space 30 minutes postcontusion to achieve the following epidural temperatures: 24 +/- 2.3 degrees C (16 rats), 30 +/- 2.4 degrees C (13 rats), and 35 +/- 0.9 degrees C (13 rats). Hypothermia was continued for 3 hours when a 45-minute period of rewarming was instituted. In a fourth group a moderate contusion only was induced in 14 animals. Rectal (core) and T9-10 (epidural) temperatures were measured continuously. Locomotor testing, using the Basso-Beattie-Bresnahan (Ba-Be-Br) scale, was performed for 6 weeks, and rats were videotaped for subsequent analysis. The lesion/preserved tissue ratio was calculated throughout the entire lesion cavity and the total lesion, spinal cord, and spared tissue volumes were determined. The rostral and caudal extent of gray matter loss was also measured. At 6 weeks locomotor recovery was similar in all groups (mean Ba-Be-Br Scale scores 14.88 +/- 3.71, 14.83 +/- 2.81, 14.50 +/- 2.24, and 14.07 +/- 2.39 [p = 0.77] for all four groups, respectively). No significant differences in spared tissue volumes were found when control and treatment groups were compared, but gray matter preservation was reduced in the infusion-treated groups. Regional cooling applied 30 minutes after a moderate contusive SCI was not beneficial in terms of tissue sparing, neuronal preservation, or locomotor outcome. This method of cooling may reduce blood flow in the injured spinal cord and exacerbate secondary injury.

  18. Non-heparinized ECMO serves a rescue method in a multitrauma patient combining pulmonary contusion and nonoperative internal bleeding: a case report and literature review.

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    Wen, Pei-Hung; Chan, Wai Hung; Chen, Ying-Cheng; Chen, Yao-Li; Chan, Chien-Pin; Lin, Ping-Yi

    2015-01-01

    Pulmonary contusion and acute respiratory distress syndrome (ARDS) is a common manifestation in polytraumatic patients. Although mechanical ventilation is still the first choice of treatment, a group of patients are still unable to maintain their oxygenation. The role of extracorporeal membrane oxygenation (ECMO) has been more clarified when the lung is extensively damaged and when conventional modality failed. ECMO provides the lung an opportunity to rest by permitting reduced ventilator settings and limiting further barotraumas. However, ECMO is still considered contraindicated in polytramatic patients combining pulmonary contusion and other organ hemorrhage because of systemic anticoagulation during the treatment. We herein report a patient who successfully survive a multitrauma combining pulmonary contusion and grade IV liver laceration using non-heparinized venovenous extracorporeal membrane oxygenation (vv-ECMO). The associated literature were reviewed.

  19. Forced exercise as a rehabilitation strategy after unilateral cervical spinal cord contusion injury.

    Science.gov (United States)

    Sandrow-Feinberg, Harra R; Izzi, Jessica; Shumsky, Jed S; Zhukareva, Victoria; Houle, John D

    2009-05-01

    Evaluation of locomotor training after spinal cord injury (SCI) has primarily focused on hind limb recovery, with evidence of functional and molecular changes in response to exercise. Since trauma at a cervical (C) level is common in human SCI, we used a unilateral C4 contusion injury model in rats to determine whether forced exercise (Ex) would affect spinal cord biochemistry, anatomy, and recovery of fore and hind limb function. SCI was created with the Infinite Horizon spinal cord impactor device at C4 with a force of 200 Kdyne and a mean displacement of 1600-1800 microm in adult female Sprague-Dawley rats that had been acclimated to a motorized exercise wheel apparatus. Five days post-operatively, the treated group began Ex on the wheel for 20 min per day, 5 days per week for 8 weeks. Wheel speed was increased daily according to the abilities of each animal up to 14 m/min. Control rats were handled daily but were not exposed to Ex. In one set of animals experiencing 5 days of Ex, there was a moderate increase in brain-derived neurotrophic factor (BDNF) and heat shock protein-27 (HSP-27) levels in the lesion epicenter and surrounding tissue. Long-term (8 weeks) survival groups were exposed to weekly behavioral tests to assess qualitative aspects of fore limb and hind limb locomotion (fore limb scale, FLS and BBB [Basso, Beattie, and Bresnahan locomotor rating scale]), as well as sensorimotor (grid) and motor (grip) skills. Biweekly assessment of performance during wheel walking examined gross and fine motor skills. The FLS indicated a significant benefit of Ex during weeks 2-4. The BBB test showed no change with Ex at the end of the 8-week period, however hind limb grid performance was improved during weeks 2-4. Lesion size was not affected by Ex, but the presence of phagocytic and reactive glial cells was reduced with Ex as an intervention. These results suggest that Ex alone can influence the evolution of the injury and transiently improve fore and hind limb

  20. A re-assessment of erythropoietin as a neuroprotective agent following rat spinal cord compression or contusion injury.

    Science.gov (United States)

    Pinzon, Alberto; Marcillo, Alexander; Pabon, Diego; Bramlett, Helen M; Bunge, Mary Bartlett; Dietrich, W Dalton

    2008-09-01

    This study was initiated due to an NIH "Facilities of Research--Spinal Cord Injury" contract to support independent replication of published studies that appear promising for eventual clinical testing. We repeated a study reporting the beneficial effects of recombinant human erythropoietin (rhEPO) treatment after spinal cord injury (SCI). Moderate thoracic SCI was produced by two methods: 1) compression due to placement of a modified aneurysm clip (20 g, 10 s) at the T3 spinal segment (n=45) [followed by administration of rhEPO 1000 IU/kg/IP in 1 or 3 doses (treatment groups)] and 2) contusion by means of the MASCIS impactor (n = 42) at spinal T9 (height 12.5 cm, weight 10 g) [followed by the administration of rhEPO 5000 IU/kg/IP for 7d or single dose (treatment groups)]. The use of rhEPO following moderate compressive or contusive injury of the thoracic spinal cord did not improve the locomotor behavior (BBB rating scale). Also, secondary changes (i.e. necrotic changes followed by cavitation) were not significantly improved with rhEPO therapy. With these results, although we cannot conclude that there will be no beneficial effect in different SCI models, we caution researchers that the use of rhEPO requires further investigation before implementing clinical trials.

  1. Time-dependent Expression of MMP-2 and TIMP-2 after Rats Skeletal Muscle Contusion and Their Application to Determine Wound Age.

    Science.gov (United States)

    Yu, Tian-shui; Li, Zhuang; Zhao, Rui; Zhang, Yan; Zhang, Zhen-hua; Guan, Da-wei

    2016-03-01

    The ability to determine vitality and estimate the survival period after a wound is critical in routine forensic practice. The mRNA levels of MMP-2 and TIMP-2 were examined using quantitative real-time RT-PCR to determine the age of a wound. Furthermore, the colocalization of them with Macrophage Marker, respectively, was detected by double immunofluorescence, and a standardized rat model of skeletal muscle contusion was established. In the antemortem contused groups, a large number of macrophages showed positive staining for MMP-2 and TIMP-2, and the expression of MMP-2 and TIMP-2 mRNA increased sharply at 3 days postinjury, with relative quantities of 5.75 and 2.98. No samples in the other groups showed relative quantities of >5.75 and 2.98; therefore, relative quantities exceeding 5.75 and 2.98 were strongly indicated 3 days after contusion. In addition, there was a significant decrease in the relative quantity in the postmortem contused groups, indicating that they were useful for diagnosing vitality.

  2. Time-dependent Appearances of Myofibroblasts during the Re-pair of Contused Skeletal Muscle in Rat and Its Application for Wound Age Determination

    Institute of Scientific and Technical Information of China (English)

    YU Tian-shui; GUAN Da-wei; CHANG Lin; WANG Xu; ZHAO Rui; ZHANG Hai-dong; BAI Ru-feng

    2015-01-01

    Objective To research the relation between the time-dependent appearances of myofibroblasts during the repair of contused skeletal muscle in rat and wound age determination. Methods A total of 35 SD male rats were divided into the control and six injured groups according to wound age as fol-lows: 12 h, 1 d, 5 d, 7 d, 10 d and 14 d after injury. The appearances of myofibroblasts were detected by HE staining, immunohistochemistry and confocal laser scanning microscopy. Masson’s trichrome staining was utilized to examine collagen accumulation in the contused areas. Results Immunohistochemical stain-ing showed that α-SMA+ myofibroblasts were initially observed at 5 d post-injury. The average ratio of myofibroblasts was highest at 14 d post-injury, with all samples, ratios more than 50%. In the other five groups, the average of α-SMA positive ratios were less than 50%. The collagen stained areas in the contused zones, concomitant with myofibroblast appearance, were increasingly augmented along with ad-vances of posttraumatic interval. Conclusion The immunohistochemical detection of myofibroblasts can be applied to wound age determination. The myofibroblasts might be involved in collagen deposition during the repair of contused skeletal muscle in rat.

  3. Evaluation of the anatomical and functional consequences of repetitive mild cervical contusion using a model of spinal concussion.

    Science.gov (United States)

    Jin, Ying; Bouyer, Julien; Haas, Christopher; Fischer, Itzhak

    2015-09-01

    Spinal cord concussion is characterized by a transient loss of motor and sensory function that generally resolves without permanent deficits. Spinal cord concussions usually occur during vehicular accidents, falls, and sport activity, but unlike brain concussions, have received much less attention despite the potential for repeated injury leading to permanent neurological sequelae. Consequently, there is no consensus regarding decisions related to return to play following an episode of spinal concussion, nor an understanding of the short- and long-term consequences of repeated injury. Importantly, there are no models of spinal concussion to study the anatomical and functional sequelae of single or repeated injury. We have developed a new model of spinal cord concussion focusing on the anatomical and behavioral outcomes of single and repeated injury. Rats received a very mild (50 kdyn, IH impactor) spinal contusion at C5 and were separated into two groups three weeks after the initial injury--C1, which received a second, sham surgery, and C2, which received a second contusion at the same site. To track motor function and recovery, animals received weekly behavioral tests--BBB, CatWalk™, cylinder, and Von Frey. Analysis of locomotor activity by BBB demonstrated that rats rapidly recovered, regaining near-normal function by one week after the first and second injury, which was confirmed using the more detailed CatWalk™ analysis. The cylinder test showed that a single contusion did not induce significant deficits of the affected limb, but that repeated injury resulted in significant alteration in paw preference, with animals favoring the unaffected limb. Intriguingly, Von Frey analysis demonstrated an increased sensitivity in the contralateral hindlimb in the C2 group vs. the C1 group. Anatomical analyses revealed that while the lesion volume of both groups was minimal, the area of spared white matter in the C2 group was significantly reduced 1 and 2mm rostral to

  4. N-terminal pro-B-type natriuretic peptide as a marker of blunt cardiac contusion in trauma.

    Science.gov (United States)

    Dogan, Halil; Sarikaya, Sezgin; Neijmann, Sebnem Tekin; Uysal, Emin; Yucel, Neslihan; Ozucelik, Dogac Niyazi; Okuturlar, Yıldız; Solak, Suleyman; Sever, Nurten; Ayan, Cem

    2015-01-01

    Cardiac contusion is usually caused by blunt chest trauma and, although it is potentially a life-threatening condition, the diagnosis of a myocardial contusion is difficult because of non-specific symptoms and the lack of an ideal test to detect myocardial damage. Cardiac enzymes, such as creatine kinase (CK), creatine kinase MB fraction (CK-MB), cardiac troponin I (cTn-I), and cardiac troponin T (cTn-T) were used in previous studies to demonstrate the blunt cardiac contusion (BCC). Each of these diagnostic tests alone is not effective for diagnosis of BCC. The aim of this study was to investigate the serum heart-type fatty acid binding protein (h-FABP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), CK, CK-MB, and cTn-I levels as a marker of BCC in blunt chest trauma in rats. The eighteen Wistar albino rats were randomly allocated to two groups; group I (control) (n=8) and group II (blunt chest trauma) (n=10). Isolated BCC was induced by the method described by Raghavendran et al. (2005). All rats were observed in their cages and blood samples were collected after five hours of trauma for the analysis of serum h-FABP, NT-pro BNP, CK, CK-MB, and cTn-I levels. The mean serum NT-pro BNP was significantly different between group I and II (10.3 ± 2.10 ng/L versus 15.4 ± 3.68 ng/L, respectively; P=0.0001). NT-pro BNP level >13 ng/ml had a sensitivity of 87.5%, a specificity of 70%, a positive predictive value of 70%, and a negative predictive value of 87.5% for predicting blunt chest trauma (area under curve was 0.794 and P=0.037). There was no significant difference between two groups in serum h-FABP, CK, CK-MB and c Tn-I levels. A relation between NT-Pro BNP and BCC was shown in this study. Serum NT-proBNP levels significantly increased with BCC after 5 hours of the blunt chest trauma. The use of NT-proBNP as an adjunct to other diagnostic tests, such as troponins, electrocardiography (ECG), chest x-ray and echocardiogram may be beneficial for diagnosis of

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

    Directory of Open Access Journals (Sweden)

    Lívia Maria Vitório Trindade

    2009-03-01

    Full Text Available O tratamento da contusão pulmonar quando instituído de forma correta é bastante simples na maioria das vezes. As alterações fisiopatológicas acontecem como decorrência dos efeitos produzidos pela perda da integridade da parede torácica, acúmulo de líquidos na cavidade pleural, obstrução da via aérea e disfunção pulmonar. A manobra de recrutamento alveolar consiste na reabertura de áreas pulmonares colapsadas através do aumento da pressão inspiratória na via aérea. O objetivo deste relato foi apresentar um caso de contusão pulmonar, avaliando a efetividade da manobra de recrutamento alveolar e revisão da literatura. Paciente do sexo masculino, 33 anos, com quadro clínico de trauma de tórax bilateral e trauma crânio-encefálico, evoluiu com rebaixamento do nível de consciência, insuficiência respiratória aguda, choque hipovolêmico, hemoptise. Foi submetido a toracocentese, drenagem torácica bilateral e submetido a ventilação mecânica invasiva. Após 48 horas de ventilação mecânica invasiva, segundo os preceitos da estratégia protetora, iniciou-se manobras de recrutamento alveolar modo, Pressão controlada 10 cmH2O, freqüência respiratória 10rpm, tempo inspiratório 3.0, pressão positiva no final da expiração 30 cmH2O, FIO2 100%, durante dois minutos. Após a aplicação da manobra de recrutamento alveolar O paciente apresentou melhora pulmonar significativa da oxigenação, caracterizada por aumento da relação PaO2/FiO2, porém houve variação da mesma entre 185 a 322. Obteve alta da unidade na terapia intensiva após 22 dias e hospitalar após 32 dias da admissão. A manobra de recrutamento alveolar neste paciente apresentou resultados significativos no tratamento da contusão pulmonar, melhorando a oxigenação arterial, prevenindo o colapso alveolar e revertendo quadros de atelectasias.Treatment of pulmonary contusion when adequately established is very simple in most cases. Pathophysiological

  6. 肺挫伤患者的舒适护理%Comfortable nursing on patients with pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    李向莉; 张振坤

    2015-01-01

    舒适护理模式包括生理上的舒适护理、环境舒适的护理、心理的舒适护理、社会的舒适护理、灵性的舒适护理。本文通过对肺挫伤患者实施舒适护理模式提高了患者的疗效,减轻了患者的病痛。%Comfortable nursing mode included physical comfortable nursing,environmental comfortable nursing,psychological comfortable nursing and social,spiritual comfortable nursing.In this article,comfortable nursing applied to patients with pulmonary contusion improved the curative effect of patients and reduce the patient's pain.

  7. A wakeboarding injury presented as acute carpal syndrome and median nerve contusion after wrist strangulation: a case report

    Science.gov (United States)

    2009-01-01

    Background We present a case of combined median nerve contusion with immediate loss of sensation after the strangulation with a wakeboarding rope and prolonged referral to our department 72 hours after the injury accompanied by an acute carpal tunnel syndrome with immediate relief of numbness of a significant proportion of the median nerve following surgical decompression. Case presentation The palmar branch of the median nerve was surrounded by a significant haematoma in addition to the strangulation damage caused by its more superficial location in contrast to the median nerve. Conclusion In case of acute median neuropathy, urgent surgical intervention with exploration, decompression of both, the median nerve and the superficial branch of the median nerve, accompanied by compartment measurements of the forearm should be performed to regain or re-establish neurological integrity. PMID:19178709

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

    Directory of Open Access Journals (Sweden)

    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

  9. Mechanical Design and Analysis of a Unilateral Cervical Spinal Cord Contusion Injury Model in Non-Human Primates.

    Science.gov (United States)

    Sparrey, Carolyn J; Salegio, Ernesto A; Camisa, William; Tam, Horace; Beattie, Michael S; Bresnahan, Jacqueline C

    2016-06-15

    Non-human primate (NHP) models of spinal cord injury better reflect human injury and provide a better foundation to evaluate potential treatments and functional outcomes. We combined finite element (FE) and surrogate models with impact data derived from in vivo experiments to define the impact mechanics needed to generate a moderate severity unilateral cervical contusion injury in NHPs (Macaca mulatta). Three independent variables (impactor displacement, alignment, and pre-load) were examined to determine their effects on tissue level stresses and strains. Mechanical measures of peak force, peak displacement, peak energy, and tissue stiffness were analyzed as potential determinants of injury severity. Data generated from FE simulations predicted a lateral shift of the spinal cord at high levels of compression (>64%) during impact. Submillimeter changes in mediolateral impactor position over the midline increased peak impact forces (>50%). Surrogate cords established a 0.5 N pre-load protocol for positioning the impactor tip onto the dural surface to define a consistent dorsoventral baseline position before impact, which corresponded with cerebrospinal fluid displacement and entrapment of the spinal cord against the vertebral canal. Based on our simulations, impactor alignment and pre-load were strong contributors to the variable mechanical and functional outcomes observed in in vivo experiments. Peak displacement of 4 mm after a 0.5N pre-load aligned 0.5-1.0 mm over the midline should result in a moderate severity injury; however, the observed peak force and calculated peak energy and tissue stiffness are required to properly characterize the severity and variability of in vivo NHP contusion injuries.

  10. High-frequency transcutaneous electrical nerve stimulation alleviates spasticity after spinal contusion by inhibiting activated microglia in rats.

    Science.gov (United States)

    Hahm, Suk-Chan; Yoon, Young Wook; Kim, Junesun

    2015-05-01

    Transcutaneous electrical nerve stimulation (TENS) can be used as a physical therapy for spasticity, but the effects of TENS on spasticity and its underlying mechanisms remain unclear. The purpose of this study was to test the effects of TENS on spasticity and the role of activated microglia as underlying mechanisms of TENS treatment for spasticity in rats with a 50-mm contusive spinal cord injury (SCI). A spinal contusion was made at the T12 spinal segment in adult male Sprague-Dawley rats using the NYU impactor. Behavioral tests for motor function were conducted before and after SCI and before and after TENS application. To assess spasticity, the modified Ashworth scale (MAS) was used before and after SCI, high-frequency (HF)/low-frequency (LF) TENS application at 3 different intensities (motor threshold [MT], 50% and 90% MT) or minocycline administration. Immunohistochemistry for microglia was performed at the lumbar spinal segments. Motor recovery reached a plateau approximately 28 days after SCI. Spasticity was well developed and was sustained above the MAS grade of 3, beginning at 28 days after SCI. HF-TENS at 90% MT significantly alleviated spasticity. Motor function did not show any significant changes with LF- or HF-TENS treatment. HF-TENS significantly reduced the proportion of activated microglia observed after SCI. Minocycline, the microglia inhibitor, also significantly alleviated spasticity with the reduction of activated microglia expression. These results suggest that HF-TENS at 90% MT alleviates spasticity in rats with SCI by inhibiting activated microglia. © The Author(s) 2014.

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

    Science.gov (United States)

    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

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

    Science.gov (United States)

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

    2017-08-10

    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.

  13. A re-assessment of minocycline as a neuroprotective agent in a rat spinal cord contusion model.

    Science.gov (United States)

    Pinzon, Alberto; Marcillo, Alexander; Quintana, Ada; Stamler, Sarah; Bunge, Mary Bartlett; Bramlett, Helen M; Dietrich, W Dalton

    2008-12-03

    This study was initiated due to an NIH "Facilities of Research--Spinal Cord Injury" contract to support independent replication of published studies that could be considered for a clinical trial in time. Minocycline has been shown to have neuroprotective effects in models of central nervous system injury, including in a contusive spinal cord injury (SCI) model at the thoracic level. Beneficial effects of minocycline treatment included a significant improvement in locomotor behavior and reduced histopathological changes [Lee, S.M., Yune, T.Y., Kim, S.J., Park, D.O.W., Lee, Y.K., Kim, Y.C., Oh, Y.J., Markelonis, G.J., Oh, T.H., 2003. Minocycline reduces cell death and improves functional recovery after traumatic spinal cord injury in the rat. J Neurotrauma. 20, 1017-1027.] To verify these important observations, we repeated this study in our laboratory. The NYU (MASCIS) Impactor was used to produce a moderate cord lesion at the vertebral level T9-T10 (height 12.5 mm, weight 10 g), (n=45), followed by administration of minocycline, 90 mg/kg (group 1: minocycline IP, n=15; group 2: minocycline IV, n=15; group 3: vehicle IP, n=8; group 4: vehicle IV, n=7) immediately after surgery and followed by two more doses of 45 mg/kg/IP at 12 h and 24 h. Open field locomotion (BBB) and subscores were examined up to 6 weeks after SCI and cords were processed for quantitative histopathological analysis. Administration of minocycline after SCI did not lead to significant behavioral or histopathological improvement. Although positive effects with minocycline have been reported in several animal models of injury with different drug administration schemes, the use of minocycline following contusive SCI requires further investigation before clinical trials are implemented.

  14. Characterization of traumatic brain injury in human brains reveals distinct cellular and molecular changes in contusion and pericontusion.

    Science.gov (United States)

    Harish, Gangadharappa; Mahadevan, Anita; Pruthi, Nupur; Sreenivasamurthy, Sreelakshmi K; Puttamallesh, Vinuth N; Keshava Prasad, Thottethodi Subrahmanya; Shankar, Susarla Krishna; Srinivas Bharath, Muchukunte Mukunda

    2015-07-01

    Traumatic brain injury (TBI) contributes to fatalities and neurological disabilities worldwide. While primary injury causes immediate damage, secondary events contribute to long-term neurological defects. Contusions (Ct) are primary injuries correlated with poor clinical prognosis, and can expand leading to delayed neurological deterioration. Pericontusion (PC) (penumbra), the region surrounding Ct, can also expand with edema, increased intracranial pressure, ischemia, and poor clinical outcome. Analysis of Ct and PC can therefore assist in understanding the pathobiology of TBI and its management. This study on human TBI brains noted extensive neuronal, astroglial and inflammatory changes, alterations in mitochondrial, synaptic and oxidative markers, and associated proteomic profile, with distinct differences in Ct and PC. While Ct displayed petechial hemorrhages, thrombosis, inflammation, neuronal pyknosis, and astrogliosis, PC revealed edema, vacuolation of neuropil, axonal loss, and dystrophic changes. Proteomic analysis demonstrated altered immune response, synaptic, and mitochondrial dysfunction, among others, in Ct, while PC displayed altered regulation of neurogenesis and cytoskeletal architecture, among others. TBI brains displayed oxidative damage, glutathione depletion, mitochondrial dysfunction, and loss of synaptic proteins, with these changes being more profound in Ct. We suggest that analysis of markers specific to Ct and PC may be valuable in the evaluation of TBI pathobiology and therapeutics. We have characterized the primary injury in human traumatic brain injury (TBI). Contusions (Ct) - the injury core displayed hemorrhages, inflammation, and astrogliosis, while the surrounding pericontusion (PC) revealed edema, vacuolation, microglial activation, axonal loss, and dystrophy. Proteomic analysis demonstrated altered immune response, synaptic and mitochondrial dysfunction in Ct, and altered regulation of neurogenesis and cytoskeletal architecture in

  15. Secondary effects of femoral instrumentation on pulmonary physiology in a standardised sheep model: what is the effect of lung contusion and reaming?

    Science.gov (United States)

    Hildebrand, Frank; Giannoudis, Peter; van Griensven, Martijn; Chawda, Majur; Probst, Christian; Harms, Oliver; Harwood, Paul; Otto, Karl; Fehr, M; Krettek, Christian; Pape, Hans-Christoph

    2005-04-01

    Intramedullary nailing is the treatment of choice for patients with femoral shaft fractures. However, there is an ongoing debate in multiple trauma patients with associated lung contusion when primary or secondary definitive stabilisation of the long bone fracture should be performed, as nailing is thought to play an important role in the pathogenesis of adult respiratory distress syndrome (ARDS). In a standardised sheep model, this study aimed to quantify the development of acute pulmonary endothelial changes, to assess the activation of polymorphonuclear leucocytes (PMNL) and to observe the effects on the coagulation system associated with the reamed nailing procedure. Furthermore, the effect of coexisting lung contusion in an experimental model was evaluated. The animals were randomly assigned to one of four different groups (6 animals/group). In control groups, only a sham operation (thoracotomy) was performed, whereas in study groups, lung contusion was induced prior to femoral stabilisation either by external fixation or reamed femoral nailing. Using bronchoalveolar lavage (BAL) pulmonary permeability changes were quantified and PMNL activation was assessed by chemiluminescence. Additionally PMNL diapedesis and interstitial lung oedema were determined by histological analysis. All animals were sacrificed 4 h after the start of the femoral instrumentation. Without an associated lung injury, instrumentation of the femoral canal with the reamed nailing technique induced a transient increase in pulmonary permeability. In the face of an induced lung contusion, reamed femoral nailing resulted in significant increases in PMNL activation, pulmonary permeability and interstitial lung oedema, compared with external fixation. Without pulmonary contusion, reaming of the femoral canal was associated with a transient increase in pulmonary permeability. This was exacerbated in the presence of lung contusion along with increased PMNL activation. External fixation did not

  16. 改良大鼠肺挫伤模型的制作方法%A method for establishment of rat model with pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    王邵华; 王晋; 陈熹; 阮征; 张洁; 郑瑾

    2013-01-01

    目的 建立一种简便、特异的大鼠单纯双肺挫伤模型,并确定最大亚致死损伤能量.方法 以自由落体砝码产生能量,通过特制的心前区保护平板将能量传导至大鼠双侧后胸壁.根据不同能量分为4组:2.1,2.4,2.7,3.0J组.伤后4h,通过动脉血气分析、三维计算机成像(3DCT)测定肺挫伤占双肺容积百分比评价肺挫伤后肺损伤程度,并行肺、心肌病理学检查确诊肺挫伤和排除心肌挫伤.结果 损伤能量3.0J组大鼠死亡率高达33%,2.4J组死亡率11%;2.7J组PaO2明显低于2.4J组(P<0.01),肺挫伤容积百分比明显高于2.4J组(P<0.01);各组PaO2与3DCT肺挫伤容积百分比均呈负相关(R2=0.762).肺活检可见出血、肺不张及中性粒细胞浸润.心肌活检未见明显肌纤维断裂等变化.结论 本研究方法可复制满意的单纯双肺挫伤模型,2.7J可视为本模型的最大亚致死损伤能量.%Objective To create an easy and specific rat model of isolated bilateral pulmonary contusion and determine the maximal sublethal injury energy.Methods Injury energy was produced by free falling weights and passed through a designed precordial shield to rats' bilateral posterolateral chest wall.The rats were divided into 2.1 J,2.4 J,2.7 J and 3.0 J groups,according to the volume of injury energy.Percentage of lung contusion volume in bilateral lung was measured by blood gas analysis and three dimensional CT (3DCT) at four hours post-injury to assess lung injury severity after contusion.Pathological examination of heart and lung tissue was performed to confirm pulmonary contusion and rule out myocardial contusion.Results Death rate in 3.0 J and 2.4 J groups was 33% and 11%,respectively.PaO2 in 2.7 J group was significantly lower than that in 2.4 J group (P < 0.01),but pulmonary contusion percentage in 2.7 J group was significantly higher than that in 2.4 J group (P <0.01).All groups showed negative correlation between PaO2 and pulmonary

  17. 40例肺挫伤的临床诊断与治疗%Clinical diagnosis and treatment of 40 patients with pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    贾伟; 于文江; 岳志

    2013-01-01

    Objective To study the clinical methods of diagnosis and effective treatment of patients with pulmonary contusion. Methods Retrospective analysis of our hospital admitted in 40 cases clinical data of patients with pulmonary contusion. Admitted Hou by chest x line, and CT check confirmed for lung contusion. Early reasonable using hormone, and antibiotics, full effective of pain, effective to oxygen, necessary Shi tracheal incision, and machinery ventilation, maintained respiratory smooth, control shock, and maintained cycle stability and timely processing merged injury, attention control infusion volume, especially limit Crystal liquid of intake volume, used restrictive liquid recovery. Results Cure of 35 cases of 40 patients, cure rate of 87. 5%, 5 deaths, with a case fatality rate 12. 5%. Cause of death: multiple fractures of multiple ribs and ARDS3 cases with severe pulmonary contusion; 1 case died of cerebral contusion and laceration; 1 case died of multiple organ failure. Conclusion Chest CT in diagnosis of pulmonary contusion preferred checking. Serious associated injury and complications are the main cause of death pulmonary contusion. Active treatment of combined injury, chest wall fixing of reasonable, limited fluid resuscitation and protective mechanical ventilation is the important way to improve the curative effect of pulmonary contusion.%目的 探讨肺挫伤患者的临床诊断和有效治疗方法.方法 回顾分析40 例肺挫伤患者的临床资料,患者入院后经胸部X 线、CT 检查确诊为肺挫伤.早期合理使用激素、抗生素,充分有效的止痛,有效给氧,必要时气管切开、机械通气,保持呼吸道通畅,防治休克、维持循环稳定并及时处理合并损伤,注意控制输液量,尤其是限制晶体液的摄入量,采用限制性液体复苏.结果 40 例患者治愈35 例,治愈率87.5%,死亡5 例,病死率为12.5%.死亡原因:多根多处肋骨骨折伴发严重肺挫伤及ARDS 3 例;1

  18. 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 (P<0.05). The up, no change, or down system 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.

  19. Human Schwann cells exhibit long-term cell survival, are not tumorigenic and promote repair when transplanted into the contused spinal cord.

    Science.gov (United States)

    Bastidas, Johana; Athauda, Gagani; De La Cruz, Gabriela; Chan, Wai-Man; Golshani, Roozbeh; Berrocal, Yerko; Henao, Martha; Lalwani, Anil; Mannoji, Chikato; Assi, Mazen; Otero, P Anthony; Khan, Aisha; Marcillo, Alexander E; Norenberg, Michael; Levi, Allan D; Wood, Patrick M; Guest, James D; Dietrich, W Dalton; Bartlett Bunge, Mary; Pearse, Damien D

    2017-08-01

    The transplantation of rodent Schwann cells (SCs) provides anatomical and functional restitution in a variety of spinal cord injury (SCI) models, supporting the recent translation of SCs to phase 1 clinical trials for human SCI. Whereas human (Hu)SCs have been examined experimentally in a complete SCI transection paradigm, to date the reported behavior of SCs when transplanted after a clinically relevant contusive SCI has been restricted to the use of rodent SCs. Here, in a xenotransplant, contusive SCI paradigm, the survival, biodistribution, proliferation and tumorgenicity as well as host responses to HuSCs, cultured according to a protocol analogous to that developed for clinical application, were investigated. HuSCs persisted within the contused nude rat spinal cord through 6 months after transplantation (longest time examined), exhibited low cell proliferation, displayed no evidence of tumorigenicity and showed a restricted biodistribution to the lesion. Neuropathological examination of the CNS revealed no adverse effects of HuSCs. Animals exhibiting higher numbers of surviving HuSCs within the lesion showed greater volumes of preserved white matter and host rat SC and astrocyte ingress as well as axon ingrowth and myelination. These results demonstrate the safety of HuSCs when employed in a clinically relevant experimental SCI paradigm. Further, signs of a potentially positive influence of HuSC transplants on host tissue pathology were observed. These findings show that HuSCs exhibit a favorable toxicity profile for up to 6 months after transplantation into the contused rat spinal cord, an important outcome for FDA consideration of their use in human clinical trials. © 2017 Wiley Periodicals, Inc.

  20. Non-heparinized ECMO serves a rescue method in a multitrauma patient combining pulmonary contusion and nonoperative internal bleeding: a case report and literature review

    OpenAIRE

    Wen, Pei-Hung; Chan, Wai Hung; Chen, Ying-Cheng; Chen, Yao-Li; Chan, Chien-Pin; Lin, Ping-Yi

    2015-01-01

    Pulmonary contusion and acute respiratory distress syndrome (ARDS) is a common manifestation in polytraumatic patients. Although mechanical ventilation is still the first choice of treatment, a group of patients are still unable to maintain their oxygenation. The role of extracorporeal membrane oxygenation (ECMO) has been more clarified when the lung is extensively damaged and when conventional modality failed. ECMO provides the lung an opportunity to rest by permitting reduced ventilator set...

  1. The Value of MRI in the Diagnosis of Bone Contusion%MRI对骨挫伤的诊断价值

    Institute of Scientific and Technical Information of China (English)

    任秀红; 刘彦锋

    2013-01-01

      目的:探讨MRI对骨挫伤的诊断价值。方法:搜集本院2010年6月~2012年4月间经MRI检查确诊的膝、踝关节骨挫伤65例进行回顾性分析,65例中男40例,女25例,年龄10~65岁,平均32岁;65例行MRI检查时间自外伤后6小时~25天,平均10天;65例患者外伤后局部出现疼痛、软组织肿胀及功能障碍;临床采用保守和对症治疗。结果:65例共显示125个病灶,其中股骨内外侧髁52个,胫骨平台48个,髌骨5个,腓骨上下段10个,距骨2个;MRI表现为不规则斑片状或地图样T1WI低信号, T2WI等或略高信号,STIR脂肪抑制序列均呈明显高信号。伴半月板撕裂15例,前交叉韧带损伤11例。结论:MRI能揭示骨挫伤的病理改变,并能判断关节周围软组织损伤情况,常规MRI检查并行脂肪抑制序列是诊断外伤性骨挫伤的最佳方法。%Objective:To investigate the value of MRI in the diagnosis of bone contusion of the knee joint and ankle joint. Methods: A retrospective analysis of 65 cases of knee and ankle bone bruise whith the performance of MRI in our hospital from 2010.6 to 2012.4, including 40 males and 25 females, aged from 10 to 65 years, in averaged of 32 years old. 65 patients suffered from posttraumatic localized pain, soft swelling and dysfunction. The time interval between the accident and the MRI examination ranged from 6 h to 25 days, in averaged of 10 days.The patients with only bone contusion were treated with conservative and symptomatic treatment. Results:A total of 125 lesions in 65 cases, including 52 distal femur, 48 tibial plateau, 5 patella, 10 fibula, 2 astragalus;MRI showed irregular patchy or map-like in T1WI low signal and T2WI etc or slightly higher than the signal shadow and STIR fat suppression sequence is obvious hyperintensity. Associated with meniscal tears in 15 cases, anterior cruciate ligament injury in 11 cases. Conclusion: MRI can reveal pathological

  2. Evaluation of Injured Axons Using Two-Photon Excited Fluorescence Microscopy after Spinal Cord Contusion Injury in YFP-H Line Mice.

    Science.gov (United States)

    Horiuchi, Hideki; Oshima, Yusuke; Ogata, Tadanori; Morino, Tadao; Matsuda, Seiji; Miura, Hiromasa; Imamura, Takeshi

    2015-07-13

    Elucidation of the process of degeneration of injured axons is important for the development of therapeutic modules for the treatment of spinal cord injuries. The aim of this study was to establish a method for time-lapse observation of injured axons in living animals after spinal cord contusion injury. YFP (yellow fluorescent protein)-H transgenic mice, which we used in this study, express fluorescence in their nerve fibers. Contusion damage to the spinal cord at the 11th vertebra was performed by IH (Infinite Horizon) impactor, which applied a pressure of 50 kdyn. The damaged spinal cords were re-exposed during the observation period under anesthesia, and then observed by two-photon excited fluorescence microscopy, which can observe deep regions of tissues including spinal cord axons. No significant morphological change of injured axons was observed immediately after injury. Three days after injury, the number of axons decreased, and residual axons were fragmented. Seven days after injury, only fragments were present in the damaged tissue. No hind-limb movement was observed during the observation period after injury. Despite the immediate paresis of hind-limbs following the contusion injury, the morphological degeneration of injured axons was delayed. This method may help clarification of pathophysiology of axon degeneration and development of therapeutic modules for the treatment of spinal cord injury.

  3. Synergistic actions of olomoucine and bone morphogenetic protein-4 in axonal repair after acute spinal cord contusion

    Institute of Scientific and Technical Information of China (English)

    Liang Chen; Jianjun Li; Liang Wu; Mingliang Yang; Feng Gao; Li Yuan

    2014-01-01

    To determine whether olomoucine acts synergistically with bone morphogenetic protein-4 in the treatment of spinal cord injury, we established a rat model of acute spinal cord contusion by impacting the spinal cord at the T8 vertebra. We injected a suspension of astrocytes derived from glial-restricted precursor cells exposed to bone morphogenetic protein-4 (GDAsBMP) into the spinal cord around the site of the injury, and/or olomoucine intraperitoneally. Olomoucine effectively inhibited astrocyte proliferation and the formation of scar tissue at the injury site, but did not prevent proliferation of GDAsBMP or inhibit their effects in reducing the spinal cord lesion cavity. Furthermore, while GDAsBMP and olomoucine independently resulted in small improve-ments in locomotor function in injured rats, combined administration of both treatments had a signiifcantly greater effect on the restoration of motor function. These data indicate that the combined use of olomoucine and GDAsBMP creates a better environment for nerve regeneration than the use of either treatment alone, and contributes to spinal cord repair after injury.

  4. New vascular tissue rapidly replaces neural parenchyma and vessels destroyed by a contusion injury to the rat spinal cord.

    Science.gov (United States)

    Casella, Gizelda T B; Marcillo, Alexander; Bunge, Mary Bartlett; Wood, Patrick M

    2002-01-01

    Blood vessels identified by laminin staining were studied in uninjured spinal cord and at 2, 4, 7, and 14 days following a moderate contusion (weight drop) injury. At 2 days after injury most blood vessels had been destroyed in the lesion epicenter; neurons and astrocytes were also absent, and few ED1+ cells were seen infiltrating the lesion center. By 4 days, laminin associated with vessel staining was increased and ED1+ cells appeared to be more numerous in the lesion. By 7 days after injury, the new vessels formed a continuous cordon oriented longitudinally through the lesion center. ED1+ cells were abundant at this time point and were found in the same area as the newly formed vessels. Astrocyte migration from the margins of the lesion into the new cordon was apparent. By 14 days, a decrease in the number of vessels in the lesion center was observed; in contrast, astrocytes were more prominent in those areas. In addition to providing a blood supply to the lesion site, protecting the demise of the newly formed vascular bridge might provide an early scaffold to hasten axonal regeneration across the injury site. (c) 2002 Elsevier Science.

  5. Toll-Like Receptor-9 (TLR9) is Requisite for Acute Inflammatory Response and Injury Following Lung Contusion.

    Science.gov (United States)

    Suresh, Madathilparambil V; Thomas, Bivin; Dolgachev, Vladislav A; Sherman, Matthew A; Goldberg, Rebecca; Johnson, Mark; Chowdhury, Aulina; Machado-Aranda, David; Raghavendran, Krishnan

    2016-10-01

    Lung contusion (LC) is a significant risk factor for the development of acute respiratory distress syndrome. Toll-like receptor 9 (TLR9) recognizes specific unmethylated CpG motifs, which are prevalent in microbial but not vertebrate genomic DNA, leading to innate and acquired immune responses. TLR9 signaling has recently been implicated as a critical component of the inflammatory response following lung injury. The aim of the present study was to evaluate the contribution of TLR9 signaling to the acute physiologic changes following LC. Nonlethal unilateral closed-chest LC was induced in TLR9 (-/-) and wild-type (WT) mice. The mice were sacrificed at 5, 24, 48, and 72-h time points. The extent of injury was assessed by measuring bronchoalveolar lavage, cells (cytospin), albumin (permeability injury), and cytokines (inflammation). Following LC, only the TLR9 (-/-) mice showed significant reductions in the levels of albumin; release of pro-inflammatory cytokines IL-1β, IL-6, and Keratinocyte chemoattractant; production of macrophage chemoattractant protein 5; and recruitment of alveolar macrophages and neutrophil infiltration. Histological evaluation demonstrated significantly worse injury at all-time points for WT mice. Macrophages, isolated from TLR9 (-/-) mice, exhibited increased phagocytic activity at 24 h after LC compared with those isolated from WT mice. TLR9, therefore, appears to be functionally important in the development of progressive lung injury and inflammation following LC. Our findings provide a new framework for understanding the pathogenesis of lung injury and suggest blockade of TLR9 as a new therapeutic strategy for the treatment of LC-induced lung injury.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. SOX2 expression is upregulated in adult spinal cord after contusion injury in both oligodendrocyte lineage and ependymal cells.

    Science.gov (United States)

    Lee, Hyun Joon; Wu, Junfang; Chung, Jumi; Wrathall, Jean R

    2013-02-01

    The upregulation of genes normally associated with development may occur in the adult after spinal cord injury (SCI). To test this, we performed real-time RT-PCR array analysis of mouse spinal cord mRNAs comparing embryonic day (E)14.5 spinal cord with intact adult and adult cord 1 week after a clinically relevant standardized contusion SCI. We found significantly increased expression of a large number of neural development- and stem cell-associated genes after SCI. These included Sox2 (sex determining region Y-box 2), a transcription factor that regulates self-renewal and potency of embryonic neural stem cells and is one of only a few key factors needed to induce pluripotency. In adult spinal cord of Sox2-EGFP mice, Sox2-EGFP was found mainly in the ependymal cells of the central canal. After SCI, both mRNA and protein levels of Sox2 were significantly increased at and near the injury site. By 1 day, Sox2 was upregulated in NG2(+) oligodendrocyte progenitor cells (OPC) in the spared white matter. By 3 days, Sox2-EGFP ependymal cells had increased proliferation and begun to form multiple layers and clusters of cells in the central lesion zone of the cord. Expression of Sox2 by NG2(+) cells had declined by 1 week, but increased numbers of other Sox2-expressing cells persisted for at least 4 weeks after SCI in both mouse and rat models. Thus, SCI upregulates many genes associated with development and neural stem cells, including the key transcription factor Sox2, which is expressed in a pool of cells that persists for weeks after SCI.

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

    Science.gov (United States)

    Franz, Steffen; Ciatipis, Mareva; Pfeifer, Kathrin; Kierdorf, Birthe; Sandner, Beatrice; Bogdahn, Ulrich; Blesch, Armin; Winner, Beate; Weidner, Norbert

    2014-01-01

    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.

  9. A reassessment of P2X7 receptor inhibition as a neuroprotective strategy in rat models of contusion injury.

    Science.gov (United States)

    Marcillo, Alexander; Frydel, Beata; Bramlett, Helen M; Dietrich, W Dalton

    2012-02-01

    These experiments were completed as part of an NIH "Facilities of Research Excellence in Spinal Cord Injury" contract to support independent replication of published studies that could be considered for eventual clinical testing. Recent studies have reported that selective inhibition of the P2X7 receptor improves both the functional and histopathological consequences of a contusive spinal cord injury (SCI) in rats. We repeated two published studies reporting the beneficial effects of pyridoxal-5'-phosphate-6-azophenyl-2'-4'-disulphonic acid (PPADS) or Brilliant blue G (BBG) treatment after SCI (Wang et al., 2004 and Peng et al., 2009). Mild thoracic SCI was first produced in Experiment 1 by means of the MASCIS impactor at T10 (height 6.25 mm, weight 10 g) followed by intraspinal administration of a P2X7 antagonist (2 μl/10 mM) after injury. Treatment with PPADS or another highly selective P2X7R antagonist Brilliant Blue G (BBG) (2 μl/02 mM) did not improve locomotive (BBB rating scale) over a 7 week period compared to vehicle treated rats. Also, secondary histopathological changes in terms of overall lesion and cavity volume were not significantly different between the PPADS, BBG, and vehicle treated animals. In the second experiment, the systemic administration of BBG (10 or 50 mg/kg, iv) 15 min, 24 and 72 h after moderate (12.5 mm) SCI failed to significantly improve motor recovery or histopathological outcome over the 6 week observational period. Although we cannot conclude that there will be no long-term beneficial effects in other spinal cord injury models using selective P2X7 receptor antagonists at different doses or treatment durations, we caution researchers that this potentially exciting therapy requires further preclinical investigations before the implementation of clinical trials targeting severe SCI patients. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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

  11. Intrathecal Acetyl-L-Carnitine Protects Tissue and Improves Function after a Mild Contusive Spinal Cord Injury in Rats.

    Science.gov (United States)

    Ewan, Eric E; Hagg, Theo

    2016-02-01

    Primary and secondary ischemia after spinal cord injury (SCI) contributes to tissue and axon degeneration, which may result from decreased energy substrate availability for cellular and axonal mitochondrial adenosine triphosphate (ATP) production. Therefore, providing spinal tissue with an alternative energy substrate during ischemia may be neuroprotective after SCI. To assess this, rats received a mild contusive SCI (120 kdyn, Infinite Horizons impactor) at thoracic level 9 (T9), which causes loss of ∼ 80% of the ascending sensory dorsal column axonal projections to the gracile nucleus. Immediately afterwards, the energy substrate acetyl-L-carnitine (ALC; 1 mg/day) or phosphate-buffered saline (PBS) was infused intrathecally (sub-arachnoid) for 6 days via an L5/6 catheter attached to a subcutaneous Alzet pump. ALC treatment improved overground locomotor function (Basso-Beattie-Breshnahan [BBB] score 18 vs. 13) at 6 days, total spared epicenter (71% vs. 57%) and penumbra white matter (90% vs. 85%), ventral penumbra microvessels (108% vs. 79%), and penumbra motor neurons (42% vs. 15%) at 15 days post-SCI, compared with PBS treatment. However, the ascending sensory projections (anterogradely traced with cholera toxin B from the sciatic nerves) and dorsal column white matter and perfused blood vessels were not protected. Furthermore, grid walking, a task we have shown to be dependent on dorsal column function, was not improved. Thus, mitochondrial substrate replacement may only be efficacious in areas of lesser or temporary ischemia, such as the ventral spinal cord and injury penumbra in this study. The current data also support our previous evidence that microvessel loss is central to secondary tissue degeneration.

  12. 严重肺挫伤的临床诊治体会%Clinical Diagnosis and Treatment of Severe Pulmonary Contusion

    Institute of Scientific and Technical Information of China (English)

    徐善明; 钮海弟; 钟金龙; 陈喜云

    2011-01-01

    目的:总结严重肺挫伤的诊治特点.方法:回顾分析2003年2月-2010年12月收治的198例严重肺挫伤[损伤严重度评分(ISS)≥20分]患者的临床资料.结果:198例患者中治愈165例,治愈率为83.3%;病死33例,病死率为16.7%.结论;胸部影像学检查是诊断严重肺挫伤的可靠依据,保持呼吸道通畅、抗体克、积极治疗合并伤、合理应用机械通气、激素和抗生素是其治疗的重要方法,早期诊断并及时处理合并伤是提高抢救成功率的关键.%Objective;To review the clinical experience of diagnosis and treatment of severe pulmonary contusion. Methods: A retrospective study was carried out in 198 cases of severe pulmonary contusion (injury severity score ≥20) from January 2003 to December 2010. Results: Among 198 cases,165 (83. 3%)cases were cured and 33(16.1%) died. Conclusions: The chest image information are reliable for the diagnosis of severe pulmonary contusion. The important methods include keeping airway clear,progressively treating shock and reasonably applying ventilation,steroids as well as antibiotics. The early diagnosis and the prompt treatment of the associated injuries are key to higher cure rate.

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

    Science.gov (United States)

    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.

  14. Clinical Observation of Modified Fuyuanhuoxue Decoction on 30 Patients with Pulmonary Contusion%复元活血汤加味治疗肺挫伤30例

    Institute of Scientific and Technical Information of China (English)

    张振坤; 周国云; 宋淑玲; 史增友; 周志明

    2012-01-01

    目的 观察复元活血汤加味治疗肺挫伤的临床疗效.方法 选择肺挫伤住院患者60例,随机分为对照组30例接受常规治疗,治疗组30例在常规治疗基础上加用复元活血汤加味,10d后复查胸片并结合患者临床表现,采用肺挫伤简易评分法进行疗效评价.结果 治疗组需行机械通气率、肺部感染发生率、急性呼吸窘迫综合征(ARDS)发生率均比对照组低,治疗组较对照组总有效率明显提高,差异具有统计学意义(P<0.05).结论 复元活血汤加味对肺挫伤具有较好治疗作用.%Objective To observe the effect of modified Fuyuanhuoxue Decoction in treating pulmonary contusion. Methods 60 inpatients with pulmonary contusion were selected and randomly divided into the treatment group (n = 30) and the control group( ra=30). Both groups received routine treatment, while the treatment group was added with modified Fuyuanhuoxue Decoctioa After 10 d,the X-ray re-examination was performed and the curative effects were evaluated by the simple pulmonary contusion scoring combined with the clinical manifestations. Results The requirement rate of mechanic ventilation and the incidence rate of pulmonary infection and acute respiratory distress syn-drome(ARDS) in treatment group were lower than those in the control group (P < 0.05).The total effective rate in the treatment group was lower than that in the control group,showing statistical difference between the two groups (P < 0. OS). Conclusion Modified Fuyuanhuoxue Decoction has better therapeutic effect on pulmonary contusion..

  15. Clinical analysis for 42 cases of traumatic flail chest with pulmonary contusion%42例连枷胸合并肺挫伤的临床分析

    Institute of Scientific and Technical Information of China (English)

    夏先进; 刘晓林; 陈瑜; 胡松林

    2011-01-01

    目的 探讨创伤性连枷胸合并肺挫伤的诊治经验.方法 回顾性分析1990年1月至2009年12月收治42例连枷胸合并肺挫伤患者的临床特点及诊治体会,其中肋骨牵引7例,手术内固定16例,呼吸机治疗12例.结果 全组42例患者治愈35例,治愈率83.3%,死亡7例,病死率16.7%.死亡原因包括双侧浮动胸壁合并严重肺挫伤及急性呼吸窘迫综合征(4例)、颅脑损伤及肝破裂(2例)、多器官功能衰竭(1例).结论 保持呼吸道通畅,恢复胸壁的稳定性,治疗肺挫伤,积极救治复合伤是治疗连枷胸合并肺挫伤患者的关键措施.%Objective to summarize the experiences for the treatment of traumatic flail chest with pulmonary contusion. Methods from January 1990 to December 2009,42 cases of flail chest with pulmonary contusion were admitted in our hospital. Data was analyzed retrospectively. 7 cases had rib traction,internal fixation was performed on 16 cases,and 12 cases were treated by mechanical ventilation. Results 35 cases of patients(83.3%) were cured and 7(16.7%) dead. The causes of death include flail chest with ARDS (4 cases) ,brain injury with hepatic rupture (2 cases) ,and MODS (1 case). Conclusion the key of management for traumatic flail chest with pulmonary contusion is to keep the air way open,restore the stability of the chest wall,and treat the pulmonary contusion and compound injury.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Reduction in antioxidant enzyme expression and sustained inflammation enhance tissue damage in the subacute phase of spinal cord contusive injury

    Directory of Open Access Journals (Sweden)

    Shyue Song-Kun

    2011-02-01

    Full Text Available Abstract Background Traumatic spinal cord injury (SCI forms a disadvantageous microenvironment for tissue repair at the lesion site. To consider an appropriate time window for giving a promising therapeutic treatment for subacute and chronic SCI, global changes of proteins in the injured center at the longer survival time points after SCI remains to be elucidated. Methods Through two-dimensional electrophoresis (2DE-based proteome analysis and western blotting, we examined the differential expression of the soluble proteins isolated from the lesion center (LC at day 1 (acute and day 14 (subacute after a severe contusive injury to the thoracic spinal cord at segment 10. In situ apoptotic analysis was used to examine cell apoptosis in injured spinal cord after adenoviral gene transfer of antioxidant enzymes. In addition, administration of chondroitinase ABC (chABC was performed to analyze hindlimb locomotor recovery in rats with SCI using Basso, Beattie and Bresnahan (BBB locomotor rating scale. Results Our results showed a decline in catalase (CAT and Mn-superoxide dismutase (MnSOD found at day 14 after SCI. Accordingly, gene transfer of SOD was introduced in the injured spinal cord and found to attenuate cell apoptosis. Galectin-3, β-actin, actin regulatory protein (CAPG, and F-actin-capping protein subunit β (CAPZB at day 14 were increased when compared to that detected at day 1 after SCI or in sham-operated control. Indeed, the accumulation of β-actin+ immune cells was observed in the LC at day 14 post SCI, while most of reactive astrocytes were surrounding the lesion center. In addition, chondroitin sulfate proteoglycans (CSPG-related proteins with 40-kDa was detected in the LC at day 3-14 post SCI. Delayed treatment with chondroitinase ABC (chABC at day 3 post SCI improved the hindlimb locomotion in SCI rats. Conclusions Our findings demonstrate that the differential expression in proteins related to signal transduction, oxidoreduction

  18. Endogenous erythropoietin level and effects of exogenous erythropoietin in a rat model of blunt chest trauma-induced pulmonary contusion.

    Science.gov (United States)

    Bakan, Vedat; Kurutaş, Ergül Belge; Çıralık, Harun; Gül, Mustafa; Çelik, Ahmet

    2016-07-01

    The present objective was to investigate endogen erythropoietin (EPO) level and relationship to oxidative stress within the first 24 hours of blunt chest trauma-induced pulmo-nary contusion (PCn) in a rat model. Thirty-five rats were divided into 3 groups. In the baseline control group (BC, n=7), rats were uninjured and untreated. In the positive control group (PC, n=21) rats were injured but untreated. In the EPO-24 group (n=7), rats were injured and a single dose of intra-peritoneal EPO (5000 IU/kg) was administered immediately after lung injury. The PC group was divided into 3 subgroups: PC-6 (n=7), PC-12 (n=7), and PC-24 (n=7). The BC group was subjected to thoracotomy, and the right lung was harvested. The PC subgroups were eu-thanized at 6, 12, and 24 hours after injury, respectively. The EPO-24 group was euthanized at the 24th hour after injury. Lung samples were obtained, levels of malondialdehyde (MDA) and EPO were analyzed, and activities of superoxide dismutase (SOD) and catalase (CAT) were then measured in homogenized lung tissue samples. Histologic damage to lung tissue in the BC group, the EPO-24 group, and PC subgroup euthanized at the 24th hour after injury were scored by a single pathologist blinded to group assignation. Mean MDA levels, as well as SOD and CAT activities, of the BC and EPO-24 groups were significantly lower than those of the PC group (p<0.005). Mean EPO concentra-tion of the PC group was significantly higher than that of the BC group (p<0.005). Lung tis-sue damage scores measured at 24 hours after injury were significantly lower in the EPO-24 group than in the PC group (p<0.005). In the present PCn rat model, EPO concentrations, as well as SOD and CAT levels, were high in lung tissue, when measured at 24 hours after PCn. When administered early after chest trauma, EPO significantly attenuated oxidative damage and tissue damage in the early phase, as assessed by biochemical markers and histologic scoring.

  19. Intraspinal transplantation of motoneuron-like cell combined with delivery of polymer-based glial cell line-derived neurotrophic factor for repair of spinal cord contusion injury

    Institute of Scientific and Technical Information of China (English)

    Alireza Abdanipour; Taki Tiraihi; Taher Taheri

    2014-01-01

    To evaluate the effects of glial cell line-derived neurotrophic factor transplantation combined with adipose-derived stem cells-transdifferentiated motoneuron delivery on spinal cord con-tusion injury, we developed rat models of spinal cord contusion injury, 7 days later, injected adipose-derived stem cells-transdifferentiated motoneurons into the epicenter, rostral and caudal regions of the impact site and simultaneously transplanted glial cell line-derived neuro-trophic factor-gelfoam complex into the myelin sheath. Motoneuron-like cell transplantation combined with glial cell line-derived neurotrophic factor delivery reduced cavity formations and increased cell density in the transplantation site. The combined therapy exhibited superior promoting effects on recovery of motor function to transplantation of glial cell line-derived neurotrophic factor, adipose-derived stem cells or motoneurons alone. These ifndings suggest that motoneuron-like cell transplantation combined with glial cell line-derived neurotrophic factor delivery holds a great promise for repair of spinal cord injury.

  20. Clinical Treatment Realize of 20 Cases of Patients with Pulmonary Contusion%20例肺挫裂伤患者的临床治疗体会

    Institute of Scientific and Technical Information of China (English)

    杨军

    2014-01-01

    Objective The clinical treatment of pulmonary contusion is to be investigated. Methods The clinical treatment data of 20 cases of patients with pulmonary contusion were selected for analysis. Results After treatment,among 20 cases of the patients,there are 19 cured cases and 1 dead case. Conclusion The respiratory secretions should be effectively removed.The tracheally intubation and mechanically ventilation should be adopted as early as possible to control respiratory and restrict activity etc.When bleeding or serious leakage occur,bleeding should be control ed timely and the part of lung should be repaired or removed.%目的:探讨肺挫裂伤的临床治疗。方法对20例肺挫裂伤患者临床治疗资料进行分析。结果20例患者经治疗,治愈19例,死亡1例。结论有效清除呼吸道分泌物、及早作气管插管机械通气控制呼吸、限制活动等。如出血不止、严重漏气时应及时剖胸控制出血、修补或切除病肺。

  1. For delayed-type contusion of lung X-ray and CT diagnosis value analysis%对于迟发型肺挫伤X线与CT诊断的价值分析

    Institute of Scientific and Technical Information of China (English)

    王波

    2012-01-01

    目的评价X线与CT对迟发型肺挫伤的诊断价值。方法回顾性的分析确诊的肺挫伤的X线及CT资料,分析其动态变化,探讨X线、CT对迟发型肺挫伤的诊断价值。结论对于有胸部外伤患者,早期X线与CT影像表现阴性,而有临床不适症状的,动态观察X线与CT影像表现,对于迟发型肺挫伤的诊断能提供可靠信息,并能进一步观察疾病的转归情况。%objective: to evaluate the x ray and CT in diagnosis of late-onset pulmonary Methods: retrospective analysis of pulmonary contusion diagnosed the x ray and CT information, analyze its dynamics, exploring the x line, the diagnostic value of CT on delayed pulmonary contusion.contusion.Conclusions: for patients with chest trauma, early x ray and CT Imaging-negative and clinical symptoms of discomfort, x-ray and CT dynamic observation of imaging, for delayed diagnosis of pulmonary contusion can provide reliable information, and further observation on the prognosis of the disease.

  2. Spiral CT in diagnosis and follow-up evaluation of chest closed pulmonary contusion%胸部闭合性肺挫伤的螺旋CT诊断和随访评价

    Institute of Scientific and Technical Information of China (English)

    陶海慧; 吴茂铸; 徐昌茶

    2013-01-01

    Objective To investigate CT findings and diagnosis,follow-up value in the chest closed pulmonary contusion.Methods The clinical and imaging data of 56 patients with pulmonary contusion were retrospectively analyzed.Results 23caseswithX-raycheck,18caseswerefoundpulmonarycontusion,and five cases were negative.CT found 56 cases of pulmonary contusion involving 13 cases of the right lung,8 cases of the left lung,35 cases of both lungs involved,a total of 135 lung lobes involvement.CT performance can be divided into three types,interstitial pulmonary contusion in 13 cases(23.2%),the substance of the pulmonary contusion in 31 cases(55.4%),the mixed pulmonary contusion in 12 patients (21.4%).After treatment,interstitial pulmonary contusion lesions were completely absorbed after 1 ~ 3 days,lesions began to absorb in the substance and mixed pulmonary contusion after 1 week and absorbed completely 3 weeks after treatment.Six cases left over from fibrosis lesions and pleural adhesions hypertrophic changes.Conclusion CT is helpful for early diagnosis of pulmonary contusion,it is the best imaging method in understanding its severity and dynamic track review of pulmonary contusion,the CT classification has important guiding value in clinical conditions and duration judgment.%目的 探讨胸部闭合性肺挫伤的CT表现及其诊断、随访价值.方法 回顾性分析56例肺挫伤病例的临床及影像学资料.结果 X 线检查23例,发现肺挫伤18例,5例为阴性;CT发现56例肺挫伤涉及右肺13例,左肺8例,两肺均受累35例,共计135叶肺叶受累,CT表现可分为3型,即间质型肺挫伤13例(23.2%),实质型肺挫伤31例(55.4%),混合型肺挫伤12例(21.4%),治疗后复查间质型肺挫伤1~3d病灶均完全吸收,实质型和混合型肺挫伤1周后病灶开始吸收,3周后病灶基本吸收,6例遗留纤维化病灶和胸膜粘连肥厚改变.结论 CT能早期诊断肺挫伤、了解其严重程度而且是动态追踪复查

  3. 急性肺挫伤的螺旋CT诊断及临床价值%Acute pulmonary contusion of spiral CT diagnosis and its clinical value

    Institute of Scientific and Technical Information of China (English)

    范晓萌; 陈琪宝; 刘海俊; 邹玉红; 张东升

    2012-01-01

    目的 探讨急性肺挫伤的螺旋CT诊断及其临床应用价值.方法 回顾性分析38例急性肺挫伤的CT表现及临床资料.结果 实质型28例,表现为单侧或双侧肺实质内沿支气管走行分布的斑片状边缘模糊密度增高影.间质型5例,表现为肺纹理不均匀性增粗、边缘模糊.磨玻璃型5例,表现为一侧或双侧局部肺野透亮度减低、其内见正常走行肺纹理的磨玻璃样影.本组中合并肺撕裂伤伴肺内血肿3例.伴其他部位不同程度损伤16例.结论 胸部螺旋CT平扫对肺挫伤诊断准确率高,能实时明确创伤的部位、性质、程度和范围,并能对临床治疗、转归和预后判断起到很好的指导作用,应作为急诊危重及复合伤患者首选的影像检查方法.%Objective To investigate acute pulmonary contusion of spiral CT diagnosis and clinical application value. Methods a retrospective analysis of 38 cases of acute pulmonary contusion CT findings and clinical data. Results 28 cases with solid type, showed unilateral or bilateral lung parenchyma along the bronchial walking distribution of patch)' fuzzy edge density increased. Interstitial type in 5 cases , for the performance of lung texture inhomogeneity thickening, edge blur. Ground glass type in 5 cases, showed unilateral or bilateral partial lung field penetrating brightness, which reduce the normal running of lung texture of ground glass opacity. The group combined with pulmonary laceration with intrapulmonary hematoma in 3 cases. With other parts of the different degree of injury in 16 cases. Conclusion thoracic spiral CT scan in pulmonary contusion with high diagnostic accuracy, real -time definitive trauma site, nature, extent and range, and to the clinical treatment, outcome and prognostic play a very good role in guiding, should serve as a critical and complex trauma patients preferred imaging method.

  4. 连枷胸伴肺挫伤92例外科治疗体会%Surgical Treatment of 92 Cases of Flail Chest with Pulmonary Contusion

    Institute of Scientific and Technical Information of China (English)

    李谦平; 张军; 王建军; 郭海周

    2012-01-01

    [Objcctivc]To summarize the clinical experience of severe flail chest with pulmonary contusion after thoracic trauma. [McthodsJClinical data of 92 patients with flail chest and pulmonary contusion in our hospital from January 2006 to June 2011 were analyzed retrospectively. Among them, 52 patients underwent surgery including lung repair, hematoma clearance and the internal fixation of key fractured rib with memory alloy encircling comprcssivc connector. The clinical efficacy was compared between surgery group and non-surgery group( n =40). [Results! All patients were cured and followed up for 3 to 6 months without death patients. Thoracic deformity, length of stay, the duration of antibiotic use, ICU stay and moderate to severe pain in surgery group were significantly lower than those in non-surgery group. In surgery group, thoracic stability increased and abnormal breathing was obviously cured. [ConclusionJIntcrnal fixation of key fractured rib with memory alloy encircling comprcssivc connector for the treatment of flail chest and pulmonary contusion can decrease the complications and is benefit for rapid rehabilitation of patients.%[目的]总结重症胸外伤连枷胸伴肺挫伤的临床经验.[方法] 回顾分析2006年1月至2011年6月期间在本院诊治的连枷胸伴肺挫伤92例,其中通过手术进行肺修补,胸腔血肿清除,同时应用记忆合金环抱式接骨板对重点肋骨骨折行内固定等治疗的52例,与同期非手术组40例比较,比较其临床疗效.[结果] 随访3~6个月,所有病例均治愈,全组无死亡病例.手术组胸廓畸形率、住院时间、抗生素使用时间、ICU住院时间、中度以上的疼痛、呼吸支持天数、肺部感染率均明显低于非手术组(P<0.05,P<0.01).[结论]应用记忆合金环抱式接骨板行重点部位肋骨骨折内固定治疗连枷胸伴肺挫伤,可以减少并发症,有利于患者的快速康复.

  5. Efficacy and tolerability of DHEP-heparin plaster in reducing pain in mild-to-moderate muscle contusions: a double-blind, randomized trial.

    Science.gov (United States)

    Hoffmann, Peter; Kopačka, Pavel; Gugliotta, Barbara; Rovati, Stefano

    2012-08-01

    To investigate if the 180-mg diclofenac epolamine and heparin sodium 5600 IU medicated plaster (DHEP-heparin) is more effective for pain reduction in mild-to-moderate contusions than the reference diclofenac epolamine 180 mg plaster (DHEP). This multicenter, multinational, prospective, double-blind versus reference comparator and versus placebo, controlled trial had balanced random assignment in three parallel treatment groups. The DHEP-heparin medicated plaster was compared to the DHEP medicated plaster and a placebo medicated plaster. A total of 331 outpatients, aged ≥18 and ≤65 years, with unilateral mild-to-moderate muscle contusion, pain on standardized movement of ≥50 mm, and superficial hematoma of ≤10 × 14 cm(2) completed the study. Plasters were applied each morning, for ≥20 hours daily for 14 consecutive days. Outcomes were assessed in three visits, over 14 days, plus patients' daily self-assessment. 05DCz/FHp11 - Eudra CT n: 2005-003829-31 Primary efficacy endpoint was mean change from baseline in pain on movement after 3 days of treatment, compared between groups. Secondary efficacy endpoints included mean daily change from baseline in pain on movement during treatment, pain level as assessed at control visits after 7 and 14 days, time (days) to hematoma disappearance based on patients' daily evaluations, rescue medication use, and overall treatment efficacy as judged by both patients and investigators. Pain progressively declined in all groups, more rapidly in DHEP-heparin recipients, compared to DHEP, and in both active treatment groups compared to placebo. Adverse events were recorded in 24 of the 355 (6.7%) exposed patients, and generally resolved without need to interrupt treatment. The DHEP-heparin plaster is superior to the reference DHEP plaster in reducing pain associated with mild-to-moderate muscle contusion. Both active treatments were significantly more effective than placebo, and each showed a comparably favorable

  6. The effect of mesenchymal stem cell transplantation on the recovery of bladder and hindlimb function after spinal cord contusion in rats

    Directory of Open Access Journals (Sweden)

    Park Jeong-Soo

    2010-09-01

    Full Text Available Abstract Background Mesenchymal stem cells are widely used for transplantation into the injured spinal cord in vivo model and for safety, many human clinical trials are continuing to promote improvements of motor and sensory functions after spinal cord injury. Yet the exact mechanism for these improvements remains undefined. Neurogenic bladder following spinal cord injury is the main problem decreasing the quality of life for patients with spinal cord injury, but there are no clear data using stem cell transplantation for the improvement of neurogenic bladder for in vivo studies and the clinical setting. The purpose of this study was to delineate the effect of human mesenchymal stem cell (hMSCs transplantation on the restoration of neurogenic bladder and impaired hindlimb function after spinal cord contusion of rats and the relationship between neurotrophic factors such as brain derived neurotrophic factor (BDNF and neurotrophin-3 (NT-3 and bladder and hindlimb functions. Results Modified moderate contusion injury were performed on the thoracic spinal cord of Sprague-Dawley rats using MASCIS impactor and hMSCs, human fibroblasts or phosphate-buffered saline were transplanted into injured spinal cord 9 days after injury for hMSC and two control groups respectively. Ladder test showed more rapid restoration of hindlimb function in hMSC group than in control group, but Basso, Beattie, and Bresnahan score and coupling score were not different significantly among hMSC and two control groups. Neurogenic bladder was not improved in either group. ED1 positive macrophages were significantly reduced in hMSC group than in two control groups, but ELISA and RT-PCR studies revealed BDNF and NT-3 levels in spinal cord and bladder were not different among hMSC and two control groups regardless the experimental duration. Conclusion hMSC transplantation was effective in reducing inflammatory reaction after spinal cord contusion of rats but not sufficient to

  7. Evisceration transanale de l�intestin grele chez l�enfant secondaire a une contusion de l�abdomen: a propos d�un cas

    Directory of Open Access Journals (Sweden)

    Papa Abdoulaye Ba

    2011-12-01

    Full Text Available L�evisceration transanale de l�intestin grele au cours d�un traumatisme ferme de l�abdomen est une situation exceptionnelle. Nous rapportons le cas d�une fille de 7 ans, recue pour un etat de choc hemorragique avec une evisceration transanale de l�intestin grele suite a une contusion de l�abdomen. Ce tableau clinique est survenu au decours d�un accident de la circulation. La laparotomie exploratrice permettait de decouvrir une plaie longitudinale de la face anterieure du rectum, situee au dessus de la reflexion peritoneale, a travers laquelle passaient les anses greles. Une suture de la plaie rectale associee a une ileostomie double apres resection du grele eviscere et un a drainage du cul-de-sac de Douglas ont ete realises. L�enfant est decede en postoperatoire precoce. A travers cette observation, les auteurs se proposent de revoir les cas precedemment decrits et de discuter les options therapeutiques.

  8. The Effect of Shengmai Injection in Treating Acute Pulmonary Contusion%生脉注射液治疗急性肺挫伤的临床观察

    Institute of Scientific and Technical Information of China (English)

    李全胜; 许海

    2011-01-01

    Objective To study the effect of Shengmai injection in treating acute pulmonary contusion. Methods 100 patients with acute pulmonary contusion were randomly divided into control group ( n = 50) and treatment group ( n = 50 ). Both groups were given routine treatment,while the patients of treatment group were given Shengmai injection in addition,50 ml Shengmai injection dissolved in 10% glucose injection 200 ml, for 7 days. Chest radiography and the clinical symptomatic, blood PaO2, PaCO2, PaO2/FiO2 before and after 7 days were observed. Results The effective percentage of treatment group and control group were 94% ,78% , respectively, the treatment group was superior to the control group( P < 0.05). After treatment, the level of blood PaO2 and PaO2/FiO2 in treatment group were higher than those in control group (P <0. 05). Conclusion Shengmai injection can increase the effective percentage on patients with acute pulmonary contusion. There was significant effect of Shengmai injection on patients with acute pulmonary contusion.%目的 观察生脉注射液治疗急性肺挫伤的临床疗效.方法 选择100例急性肺挫伤患者,随机分为对照组和治疗组,各50例.两组均给予常规西医治疗,治疗组在此基础上加用生脉注射液治疗,50 ml加入10%葡萄糖注射液200 ml中,1次/d,两组疗程均为7d.7d后复查胸片并结合患者临床表现,采用肺挫伤简易评分法进行疗效判断;同时观察患者氧分压( PaO2)、二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)变化情况.结果 治疗组和对照组临床疗效总有效率分别为94%和78%,治疗组优于对照组(P<0.05);治疗后,两组患者PaO2、PaCO2、PaO2/FiO2水平均显著升高(P<O.05或P<0.01),治疗组患者PaO2和PaO2/FiO2改善优于对照组(P均<0.05).结论 生脉注射液能明显提高急性肺挫伤患者的临床疗效,改善患者呼吸功能,对急性肺挫伤有明显治疗作用.

  9. 两种通气模式对严重肺挫伤的应用比较%Comparison of two ventilations in treating severe pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    陈亮; 易云峰; 陈检明

    2012-01-01

    目的 探讨不同模式下机械通气对严重肺挫伤患者的早期治疗效果.方法 选择35例诊断严重肺挫伤需要机械通气的患者,给予低潮气量+呼气末正压通气(PEEP)或同步间歇指令通气(SIMV)+压力支持(PSV)通气.结果 低潮气量+ PEEP组18例,SIMV+ PSV组17例.低潮气量+PEEP模式在改善低氧血症和降低吸气末峰压方面优于SIMV+ PSV模式(P <0.05).结论 低潮气量+ PEEP模式是减少呼吸机相关并发症的理想模式.%Objective To assess the early treatment of severe pulmonary contusion by using different modes of mechanical ventilation. Methods From January of 2008 to January of 2011, consecutive patients with severe pulmonary contusion were enrolled in this trial by using mechanical ventilation. All the patients were treated with lower tidal volumes + PEEP or SIMV + PSV. Results Thirty-five patients were enrolled in this trial. The samples of lower tidal volumes + PEEP and SIMV + PSV were 18 and 17, respectively. The lower tidal volumes + PEEP was more effective than SIMV + PSV, which was not only in improving hypoxemia but also in decreasing peak inspirato-ry pressure. Conclusion The lower tidal volumes + PEEP is a perfect mode for preventing the related complications in mechanical ventilation.

  10. Applying minimally invasive plastic technology in treating facial grinding contusion%微创整形技术在面部碾挫伤中的应用

    Institute of Scientific and Technical Information of China (English)

    马莉; 程维峰; 周建玺

    2013-01-01

    目的:回顾性分析面部碾挫伤患者采用微创整形技术缝合的临床效果.方法:2006年4月-2009年9月共治疗28例患者,伤口均在面部,采用精细的原位再生清创术和综合性的整形缝合技术.结果:均达到Ⅰ期愈合,恢复快,创伤小,外观自然,瘢痕不明显,无明显组织牵拉,患者对外形满意.结论:在面部碾挫伤中,综合运用微创整形技术,可以明显减轻患者的创伤,促进愈合,避免术后瘢痕及畸形的发生,是处理面部急诊外伤的好方法.%Objective Retrospectively analyze the clinical treat effect of minimally invasive orthopedic technology suture in facial grinding contusion patients. Methods From April 2006 to September 2009, 28 patients with facial wounds were treated with the fine debridement of situ regeneration and comprehensive orthopedic suture techniques. Results All patients were healed with little trauma and recoveried fastly were satisfied of physical appearance with no obvious scar and tissue retraction. Conclusion In the facial grinding contusion patients, comprehensive use of minimally invasive plastic technology can significantly reduce the trauma, promote healing and prevent postoperative scar or deformity.

  11. Pulmonary contusion is associated with toll-like receptor 4 upregulation and decreased susceptibility to pseudomonas pneumonia in a mouse model.

    Science.gov (United States)

    Southard, Robert; Ghosh, Sarbani; Hilliard, Julia; Davis, Chris; Mazuski, Cristina; Walton, Andrew; Hotchkiss, Richard

    2012-06-01

    Pulmonary contusion is a major cause of respiratory failure in trauma patients. This injury frequently leads to immune suppression and infectious complications such as pneumonia. The mechanism whereby trauma leads to an immune-suppressed state is poorly understood. To further study this phenomenon, we developed an animal model of pulmonary contusion (PC) complicated by pneumonia and assessed the effect of PC and pneumonia on toll-like receptor expression in alveolar macrophages. Using a mouse model, PC was induced on the right lung, and pneumonia was induced with Pseudomonas aeruginosa (Pa) injected intratracheally 48 h after injury. Susceptibility to pneumonia was assessed by mortality at 7 days. Uninjured animals were used as controls. Bronchoalveolar lavage fluid and blood were assayed 48 h after injury and 24 h after Pa instillation to look at markers of systemic inflammation. Toll-like receptor expression in the initial inflammatory response was analyzed by flow cytometry. Unexpectedly, injured animals subjected to intratracheal injection of Pa at 48 h after PC demonstrated increased survival compared with uninjured animals. Bronchoalveolar lavage cytokine expression was increased significantly after Pa administration but not after PC alone. Toll-like receptor 4 expression on alveolar macrophages was significantly elevated in the injured group compared with sham but not in neutrophils. Animals subjected to PC are more resistant to mortality from infection with Pa and display an enhanced cytokine response when subsequently subjected to Pa. Increased expression of toll-like receptor 4 on alveolar macrophages and enhanced innate immunity are a possible mechanism of increased cytokine production and decreased susceptibility to pneumonia.

  12. The clinical significance of the lung contusion in the fracture of multiple ribs%多发性肋骨骨折中肺挫伤的临床评估及意义

    Institute of Scientific and Technical Information of China (English)

    孙宝林; 余守强; 魏春生; 全勇辉; 杨小龙

    2012-01-01

    Objective To investigate the influencing factors and coping strategies of the lung contusion in the fracture of multiple ribs. Methods 76 patients with fracture of multiple ribs were divided into three groups: 20 cases without lung contusion ( group A ), 21 cases with single lung contusion ( group B ) and 35 cases with two lungs contusion ( Group C ), and clinical parameters of three groups were analyzed. Results The numbers of rib fracture, multiple injury severity score ( 1SS ), chest concise trauma score ( A1S ), rib fractures range, flail chest situation, hemopneumothorax situation and oxygen saturation during hospitalization, respiratory support methods and respiratory support time were statistically significant between A, B and C ( P < 0. 05 ). Conclusion The severity of of lung contusion in fracture of multiple ribs is affected by many factors, and the lung contusion is an independent risk factor, and early support for breathing and handling associated injuries is the key to successful treatment.%目的 探讨多发性肋骨骨折中肺挫伤对伤情的影响因素及应对策略.方法 分析多发性肋骨骨折中20例无肺挫伤(A组)、21例单肺挫伤(B组)和35例双肺挫伤(C组)的相关临床参数.结果 经秩和检验呼吸机支持时间、肋骨骨折数、多发伤评分(ISS评分)、胸部简明创伤评分(AIS),A与B、C两组有统计学意义(P<0.05),经卡方检验肋骨骨折范围、受伤原因、连枷胸、住院期间血气胸情况、住院期间氧饱和度及呼吸支持方式,A、B及C三组均有统计学意义(P<0.05).结论 多发性肋骨骨折中肺挫伤范围及严重程度受多种因素影响,是独立危险因素,早期支持呼吸,处理合并伤是救治成功的关键.

  13. Application of visual evoked potential in diagnosis and prognosis of optic nerve contusion%视觉诱发电位在视神经挫伤诊断及预后中的应用

    Institute of Scientific and Technical Information of China (English)

    贾艳红; 王保贞; 高水杰

    2011-01-01

    目的 探讨视觉诱发电位(VEP)的异常率对视神经挫伤诊断及预后估计.方法 对69例(69眼)单侧眼挫伤组进行视力检查及VEP检查,以自体健侧眼为对照组.分析两组间VEP P100波幅值及P100峰潜时值,记录单侧眼挫伤患者的伤眼、对侧眼及治疗后伤眼的VEP.结果 挫伤眼VEP P100波幅明显降低,P100峰潜时明显延长,挫伤眼各视力组VEP异常率明显高于对照组,挫伤眼矫正视力<0.1者VEP异常更明显且预后差.结论 VEP是一种客观、定量、定位评定视神经功能的方法,是目前视神经病变最敏感、早期诊断、判断预后的客观检查方法,对视觉功能评价有重要的临床价值.%Objective To investigate the visual evoked potential abnormalities rate on the diagnosis and prognosis of optic nerve contusion.Methods Unilateral contusion of 69 for visual acuity and VEP examination to the contralateral eye as control self.Analysis of VEP P100 amplitude between the two groups and the time value of P100 peak latencies.Records of patients with unilateral contusion injury eyes,fellow eyes and eye injuries after treatment of visual evoked potentials.Results Contusion eye VEP P100 amplitude was significantly lower,P100 peak latency was significantly longer,the VEP abnormalities in visual acuity eye contusion group was significantly higher,Contusion eye vision correction < 0.1 VEP abnormalities was more obvious and had poor prognosis.Conclusions VEP is an objective,quantitative assessment of optic nerve function positioning method,optic neuropathy is the most sensitive,early diagnosis,prognosis and objective examination methods,evaluation of visual function has important clinical value.

  14. 肺挫伤对连枷胸手术内固定疗效的影响%Internal fixation for traumatic flail chest with concomitant pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    吴国栋; 彭学锋; 罗伟彬

    2013-01-01

    目的:探讨手术内固定治疗连枷胸合并肺损伤的疗效以及肺挫伤对疗效的影响.方法:回顾性分析2002年1月至201 1年12月深圳市第二人民医院收治的62例连枷胸合并肺损伤患者的临床资料,其中内固定组24例、保守治疗组38例,肺挫伤简易评分法0~6分37例(A组,其中保守治疗22例、内固定15例)、7 ~18分25例(B组,其中保守治疗16例、内固定9例),比较呼吸机支持例数、呼吸机支持时间、住院时间及死亡例数等指标的差异.结果:(1)保守治疗组和内固定组呼吸机支持例数、呼吸机支持时间、住院时间、死亡例数比较,差异无统计学意义(P>0.05).(2)A组中保守治疗和内固定治疗患者呼吸机支持例数、呼吸机支持时间、住院时间比较,差异有统计学意义(P<0.05).(3)B组中保守治疗和内固定治疗患者患者呼吸机支持例数、呼吸机支持时间、住院时间分、死亡例数比较,差异无统计学意义(P>0.05).结论:连枷胸合并轻度肺挫伤经内固定治疗,可迅速改善患者呼吸功能;而合并严重肺挫伤的连枷胸患者内固定术后呼吸功能改善不够理想.%Objective:To study the effects of internal fixation for the treatment of traumatic flail chest with concomitant lung injury and pulmonary contusion.Methods:We did a retrospective analysis on the clinical profiles of 62 patients with traumatic flail chest and concomitant lung injury admitted to Shenzhen Second People's Hospital between January 2002 and December 2011,of whom 38 received conservative treatment and 24 internal fixation.37 patients rated the score of 0 to 6 for simple pulmonary contusion scale (group A,in whom 22 received conservative treatment and 15 internal fixation),and 25 patients rated the score of 7 to 18 for simple pulmonary contusion scale (group B,in whom 16 received conservative treatment and 9 internal fixation).The difference in the number of cases requiring and the duration

  15. 氨溴索在肺挫伤治疗中的作用%Effect of ambroxol in treatment of pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    曹祥; 邓波荣; 严四军; 刘燕; 黄洁健; 乔德成

    2011-01-01

    Objective To investigate the therapeutic action of ambroxol in treatment of pulmonary contusion. Methods Sixty-three patients with pulmonary contusion in our department from May 2008 to May 2010 were randomly divided into three groups. There were 21 patients in the control group (general treatment only) , the common dose group (general treatment with common dose of ambroxol) and the large dose group (general treatment with large dose of ambroxol) respectively. Results PaO2 in the common and large dose groups were significantly higher than that of the control group at the first day post-treatment (P <0.01) ; and PaO2 in the large dose group was significantly higher than that of the control and common groups at the seventh day post-treatment (P < 0.01) ; -PaCO2 in the common and large dose groups were obviously lower than that of the control group at the third day post-treat-ment ( P < 0.05 ) ; and SaO2 in the large dose groups was obviously higher than that of the control and common group at the third and fifth day post-treatment ( P < 0.05 ) ; time of assisted respiration with breathing machine in the large dose group was less than that of the control and common group at the fifth and seventh day post-treatment. Conclusion There is an obvious therapeutic effect to pulmonary contusion by using of ambroxol in early and full dosage. And it can significantly reduce the degree of injury of lungs.%目的 探讨氨溴索对肺挫伤的治疗作用.方法 将2008年5月-2010年5月在我科住院的肺挫伤患者63例随机分为三组,即对照组(仅给一般治疗)、常规剂量组(一般治疗+常规量氨溴索)和大剂量组(一般治疗+大剂量氨溴索)各21例.结果 治疗后第1天,常规剂量组及大剂量组的PaO2明显高于对照组PaO2 (P <0.01);治疗后第7天,大剂量组PaO2明显高于常规剂量组及对照组的PaO2(P<0.01);治疗后第3天,常规剂量组及大剂量组PaCO2明显低于对照组PaCO2(P<0.05);治疗后第3

  16. Diagnosis-therapy and analysis on 48 cases of severe pulmonary contusion%48例严重肺挫伤的诊治分析

    Institute of Scientific and Technical Information of China (English)

    张玲; 陈德昌; 景炳文

    2001-01-01

    Objective To analyzed the effect of early diagnosis-th erapy on severe pulmonary contusion.Methods 48 patients s uffered from pulmonary contusion were divided into two groups:early diagnosis-th erapy group(n=29);general therapy group(n=19).Early diagnosis-therapy includes early diagnosis,proper fluid support and glucocorticoid,et al. The morbidity of pulmonary infection,ARDS,MODS,and seps is were compared between the two groups.Results Hypoxia was improved dramatica lly in early diagnosis-therapy group.The time for ventilator therapy is obvious ly shorter in early diagnosis-therapy group than that in general therapy group.The morbidity of pulmonary infection and days of hospital stay were not significant difference between the two groups.Conclusion Early diag nosis-therapy for pulmonary contusion could markedly alleviate hypoxia,reduce the time of hospital stay,and lower the morbidity of ARDS.%目的 总结严重肺挫伤后早期诊治方法和经验。方法 将48例严重肺挫伤患者分为两组,早期诊治组29例,一般治疗组19例。早期 诊治包括早期诊断、进行科学的容量支持和配合糖皮质激素等综合救治;一般治疗指对确诊患者进行一般的呼吸支持、氧疗和容量支持等救治措施。比较两组间肺部感染、ARDS、MODS 、脓毒症等并发症的发生率,以及呼吸机使用天数和住院天数。结果 早期诊治组呼吸治疗后缺氧改善较一般治疗组快而明显(P<0.01),使用呼吸机的天数较一般治疗组明显缩短,且ARDS的发生率亦明显低于一般治疗组(P<0.05),但肺部感染发生率和住院天数两组间无明显的差异。结论 早期诊治能快速改善患者缺氧状况,减少呼吸机治疗天数,降低ARDS的发生率。

  17. Assessment of Glial Scar, Tissue Sparing, Behavioral Recovery and Axonal Regeneration following Acute Transplantation of Genetically Modified Human Umbilical Cord Blood Cells in a Rat Model of Spinal Cord Contusion.

    Directory of Open Access Journals (Sweden)

    Yana O Mukhamedshina

    Full Text Available This study investigated the potential for protective effects of human umbilical cord blood mononuclear cells (UCB-MCs genetically modified with the VEGF and GNDF genes on contusion spinal cord injury (SCI in rats. An adenoviral vector was constructed for targeted delivery of VEGF and GDNF to UCB-MCs. Using a rat contusion SCI model we examined the efficacy of the construct on tissue sparing, glial scar severity, the extent of axonal regeneration, recovery of motor function, and analyzed the expression of the recombinant genes VEGF and GNDF in vitro and in vivo.Transplantation of UCB-MCs transduced with adenoviral vectors expressing VEGF and GDNF at the site of SCI induced tissue sparing, behavioral recovery and axonal regeneration comparing to the other constructs tested. The adenovirus encoding VEGF and GDNF for transduction of UCB-MCs was shown to be an effective and stable vehicle for these cells in vivo following the transplantation into the contused spinal cord.Our results show that a gene delivery using UCB-MCs-expressing VEGF and GNDF genes improved both structural and functional parameters after SCI. Further histological and behavioral studies, especially at later time points, in animals with SCI after transplantation of genetically modified UCB-MCs (overexpressing VEGF and GDNF genes will provide additional insight into therapeutic potential of such cells.

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

    Science.gov (United States)

    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

    2017-08-09

    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 < 0.05). The diclofenac group showed reduced levels of COX-2 only in relation to the injury group (p < 0.05). COX-2 protein expression remained unchanged with all therapies except with PBMT at a 3-J dose at 12 h (p < 0.05 compared to the injury group). In addition, PBMT (1, 3, and 9 J) effectively reduced levels of cytokines TNF-α, interleukin (IL)-1β, and IL-6 at all assessed times as compared to the injury and diclofenac groups (p < 0.05). Thus, PBMT at a 3-J dose was more effective than other doses of PBMT and topical NSAIDs in the modulation of the inflammatory process caused by muscle contusion injuries.

  19. 肺挫裂伤31例CT与X线片诊断分析比较%31 Cases of CT with Pulmonary Contusion and Laceration in Comparison of Diagnosis and Analysis

    Institute of Scientific and Technical Information of China (English)

    李春洞

    2015-01-01

    目的:探讨多层螺旋CT及X线片对于肺挫裂伤的诊断价值。方法对31例临床怀疑肺挫裂伤的伤者进行临床随访、多层螺旋CT扫描、X线平片检查。并对多层螺旋CT扫描结果及X线平片检查结果进行分析。结果多层螺旋CT显示肺挫伤26例,裂伤5例。X线平片漏诊6例、误诊2例。结论多层螺旋CT能够明确诊断肺挫裂伤的部位、范围、性质、程度、合并症及进行鉴别诊断,为临床提供较X线平片更多的诊断信息、治疗依据。多层螺旋CT是目前诊断肺挫裂伤的最重要的检查方法。%Objective To explore diagnostic value of Multi-slice spiral CT (MSCT) and X-ray film on the pulmonary contusion and laceration.Methods MSCT scan and X-ray imaging were performed in 31 cases with suspected pulmonary contusion and laceration after clinical follow-up. The two sets of data were comparatively analysed.Results MSCT diagnosed 26 cases of pulmonary contusion, 5cases of laceration. X-ray missed 6 cases and misdiagnosed 2 cases.Conclusion The MSCT scan technology could definitely display the location, extent, nature, degree, complications and differential diagnosis of pulmonary contusion and laceration, providing more valuable diagnostic information and therapeutic basis than X-ray film. So MSCT is the most important method of the diagnosis of pulmonary laceration and contusion.

  20. 经外侧裂脑池开放减压治疗额颞对冲性脑挫裂伤%Opening cistern combined decompression by transsylvian surgical approach in treatment of severe bump contusion and laceration of brain

    Institute of Scientific and Technical Information of China (English)

    曾昭明; 郭予大; 邵强; 陈秋明; 冯志铁; 吴分浪

    2008-01-01

    Objective To summarize the clinical effects of opening cistern combined decompression of severe bump contusion and laceration of brain by transsylvian surgical approach. Methods Clinical data from 31 cases with severe bump contusion and laceration of brain in the decompression treatment combined with open-ing parasellar and basal cisterns by transsylvian surgical approach was analyzed retrospectively. Results Post- operative did not show visible brain edema in severe bump contusion and laceration of brain,2 cases died of brain exhaustion,2 cases died of severe complications. The Glasgow Outcome Score (COS) was determined at 3-6 months of follow-up for other 27 cases:20 cases had a good recovery,5 cases had moderate disability,2 cases were in a vegetative state. Conclusion Opening cistern combined decompression of severe bump contusion and laceration of brain by transsylvian surgical approach could alleviate secondary brain edema and improve the clin- ical effect for severe bump contusion and laceration of brain.%目的 总结经外侧裂脑池开放在对冲性脑挫裂伤减压术中的应用效果.方法 对31例额颞对冲性脑挫裂伤术中经外侧裂入路施行鞍旁脑池和基底池开放的患者进行临床资料的进行回顾性分析.结果 术后动态复查头颅CT,全部患者额颞脑挫裂伤区域未见明显脑水肿现象,2例死于脑功能衰竭,2例死于严重并发症.其余随访3~6个月,按GOS评分,良好20例,中残5例,植物状生存2例.结论 额颞对冲性脑挫裂伤术中经外侧裂施行鞍旁脑池和基底池开放减压可减轻继发性脑水肿,提高临床效果.

  1. 眼挫伤早期高眼压76例临床分析%Clinical analysis of 76 cases of ocular hypertension after ocular contusion in early stage

    Institute of Scientific and Technical Information of China (English)

    齐银征

    2014-01-01

    Objective To investigate the causes and treatment of ocular hypertension after ocular contusion in early stage.Methods The clinical data of 76 eyes of 76 cases of ocular hypertension after ocular contusion in early stage were retrospectively analyzed.Results The causes of ocular hypertension after ocular contusion in early stage were intraocular hemorrhage in 52 eyes [68.42% ; including hyphema in 50 eyes (65.79%) and vitreous hemorrhage in 2 eyes (2.63%)],anterior segment contusion with hyphema or iritis in 16 eyes (21.5%),lens luxation with hyphema or iritis in 8 eyes (10.53%).The intraocular pressure in all cases was controlled by medical treatment or surgery successfully.The visual acuities were improved obviously.Conclusion The main cause of ocular hypertemion after ocular contusion in early stage is hyphema,next is multiple factors.The patients should be treated directly to the causes.%目的 探讨眼挫伤早期发生高眼压的原因及治疗方法.方法 回顾分析76例(76眼)眼挫伤早期引起眼压升高者的临床资料.结果 本组76例中眼内出血52例占68.42%,其中前房积血50例占65.79%,玻璃体积血2例占2.63%;前房角挫伤伴前房积血、虹膜炎16例占21.05%;晶状体脱位伴前房积血或虹膜炎8例占10.53%.经药物或手术治疗,眼压均得到有效控制,视力明显恢复.结论 眼挫伤所致眼压升高前房积血是主要原因,其次为多种因素共同作用,根据病因采取有针对性的治疗.

  2. Subarachnoid Transplant of the Human Neuronal hNT2.19 Serotonergic Cell Line Attenuates Behavioral Hypersensitivity without Affecting Motor Dysfunction after Severe Contusive Spinal Cord Injury

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    Mary J. Eaton

    2011-01-01

    Full Text Available Transplant of cells which make biologic agents that can modulate the sensory and motor responses after spinal cord injury (SCI would be useful to treat pain and paralysis. To address this need for clinically useful human cells, a unique neuronal cell line that synthesizes and secretes/releases the neurotransmitter serotonin (5HT was isolated. Hind paw tactile allodynia and thermal hyperalgesia induced by severe contusive SCI were potently reversed after lumbar subarachnoid transplant of differentiated cells, but had no effect on open field motor scores, stride length, foot rotation, base of support, or gridwalk footfall errors associated with the SCI. The sensory effects appeared 1 week after transplant and did not diminish during the 8-week course of the experiment when grafts were placed 2 weeks after SCI. Many grafted cells were still present and synthesizing 5HT at the end of the study. These data suggest that the human neuronal serotonergic hNT2.19 cells can be used as a biologic minipump for receiving SCI-related neuropathic pain, but likely requires intraspinal grafts for motor recovery.

  3. Research Progress of Flail Chest with Pulmonary Contusion%连枷胸合并肺挫伤研究进展

    Institute of Scientific and Technical Information of China (English)

    刘伯夫; 王鑫

    2015-01-01

    肺挫伤(pulmonary contusion)是急诊胸部创伤中常见而严重的损伤,易引起急性呼吸窘迫综合征(ARDS)及呼吸衰竭.当今科技及交通的发展所导致的意外伤害不断增加,连枷胸(flail chest)合并肺挫伤越来越常见.其并发症较多,死亡率较高.为了能更好认识及提高对连枷胸合并肺挫伤治疗效果,我们对以下内容进行综述:①肺挫伤的病理生理改变;②连枷胸合并肺挫伤病理生理改变;③连枷胸合并肺挫伤临床表现;④肺挫伤影像学改变;⑤诊治进展.

  4. Tail nerve electrical stimulation combined with scar ablation and neural transplantation promotes locomotor recovery in rats with chronically contused spinal cord.

    Science.gov (United States)

    Zhang, Shu-xin; Huang, Fengfa; Gates, Mary; Holmberg, Eric G

    2012-05-25

    To date, few treatment strategies applying cellular transplantation to the chronically injured spinal cord have yielded significant functional improvement in animal experiments. Here we report that significant improvement of locomotor function was achieved in rats with chronic spinal cord injury (SCI) by the application of combination treatments with tail nerve electrical stimulation (TANES), which can activate the central pattern generator, inducing active weight-supported stepping. Contusion injury (25 mm) to spinal cord T10 was produced by using the NYU impactor device in female, adult Long-Evans rats. Rats in 2 of 4 groups with SCI received basic treatments (scar ablation followed by transplantation of lamina propria of olfactory mucosa and cultured olfactory ensheathing cells into the lesion cavity) 6 weeks after SCI. Rats both with and without basic treatments were subjected to TANES one week after secondary surgery or 7 weeks after SCI. Sixteen weeks after secondary surgery or 22 weeks after SCI rats in two groups receiving TANES significantly improved their functional recovery compared with those without TANES, when evaluated with BBB open field rating scale (pinjury level, which is critical for functional recovery. Additionally, TANES may promote axonal regeneration, including those from supraspinal level. Since TANES demonstrated considerable potential for achieving improvement of functional recovery in rat model, it would suggest a new strategy for chronic SCI. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Targeting RPTPσ with lentiviral shRNA promotes neurites outgrowth of cortical neurons and improves functional recovery in a rat spinal cord contusion model.

    Science.gov (United States)

    Zhou, Heng-Xing; Li, Xue-Ying; Li, Fu-Yuan; Liu, Chang; Liang, Zhi-Pin; Liu, Shen; Zhang, Bin; Wang, Tian-Yi; Chu, Tian-Ci; Lu, Lu; Ning, Guang-Zhi; Kong, Xiao-Hong; Feng, Shi-Qing

    2014-10-24

    After spinal cord injury (SCI), the rapidly upregulated chondroitin sulfate proteoglycans (CSPGs), the prominent chemical constituents and main repulsive factors of the glial scar, play an important role in the extremely limited ability to regenerate in adult mammals. Although many methods to overcome the inhibition have been tested, no successful method with clinical feasibility has been devised to date. It was recently discovered that receptor protein tyrosine phosphatase sigma (RPTPσ) is a functional receptor for CSPGs-mediated inhibition. In view of the potential clinical application of RNA interference (RNAi), here we investigated whether silencing RPTPσ via lentivirus-mediated RNA interference can promote axon regeneration and functional recovery after SCI. Neurites of primary rat cerebral cortical neurons with depleted RPTPσ exhibited a significant enhancement in elongation and crossing ability when they encountered CSPGs in vitro. A contusion model of spinal cord injury in Wistar rats (the New York University (NYU) impactor) was used for in vivo experiments. Local injection of lentivirus encoding RPTPσ shRNA at the lesion site promoted axon regeneration and synapse formation, but did not affect the scar formation. Meanwhile, in vivo functional recovery (motor and sensory) was also enhanced after RPTPσ depletion. Therefore, strategies directed at silencing RPTPσ by RNAi may prove to be a beneficial, efficient and valuable approach for the treatment of SCI. Copyright © 2014 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Variation and clinical significance of Clara cell protein in patients with pulmonary contusion%肺挫伤患者血清CC16的变化及临床意义

    Institute of Scientific and Technical Information of China (English)

    吴峰; 丁伯应; 杨小龙; 任刚; 熊克品; 徐东

    2014-01-01

    目的:探讨肺挫伤患者血清人克拉拉细胞蛋白(Clara cell protein,CC16)水平变化及临床意义。方法:应用ELISA方法检测42例肺挫伤患者(实验Ⅰ组:轻-中度肺挫伤患者24例;实验Ⅱ组:重度肺挫伤患者18例)伤后24 h内及治疗后1 d、3 d、7 d、14 d血清CC16水平变化,并与16例健康体检者(对照组)血清CC16水平进行比较。结果:实验组各个时间点血清CC16水平均高于对照组,差异具有统计学意义( P<0.01)。伤后24 h内和治疗后1 d、3 d、7 d、14 d血清CC16水平之间均有差异( P<0.01),且有逐渐下降趋势。实验Ⅱ组各个时间点血清CC16水平均较实验Ⅰ组同时间点偏高,差异有统计学意义( P<0.01)。结论:肺挫伤患者伤后早期血清CC16水平明显上升,且随治疗进程逐渐下降。血清CC16水平上升与肺挫伤程度有密切关系。血清CC16水平变化可能为肺挫伤早期诊断提供生物学指标。%Objective:To investigate the variation and clinical significance of 16kDa Clara cell protein(CC16) in patients with pulmonary contusion. Methods:Forty-two patients with pulmonary contusion were divided into experimental group I(n=24,moderate pulmonary contusion)and experimental groupⅡ(n=18,severe pulmonary contusion).Enzyme-linked immunoadsordent assay (ELISA) was used to detect the serum levels of CC16 in the two groups of patients within 24 h after the incident and at day 1,3,7 and 14 after treatment.The results were compared with another 16 healthy subjects in-cluded as controls.Results:Serum CC16 level in each time point was higher in the two experimental groups than the controls(P<0.01).The difference was significant concerning the levels of CC16 measured within 24 h after contusion and at day 1,3,7 and 14 after treatment(P<0.01),yet the levels ten-ded to decline.In addition,the levels in each time point in experimental group II were somewhat higher than group

  8. Value of three-dimensional volume-rendering CT pulmonary contusion volume measurement in prediction of ARDS development%三维CT容积再现技术行肺挫伤容积测定预测ARDS的价值

    Institute of Scientific and Technical Information of China (English)

    王邵华; 周文勇; 赵明川; 张辉; 陈晓峰

    2014-01-01

    Objective To investigate the value of three-dimensional CT volume rendering in predicting ARDS following pulmonary contusion and identifying high-risk patients.Methods Seventy-one cases of pulmonary contusion (AIS > 2 points) confirmed by chest CT during an emergency admission between July 2010 and June 2011 were enrolled.Using computer-generated three-dimensional reconstruction,contusion volume was measured and expressed as a percentage of total lung volume.The admission data,such as blood gas analysis results,systolic arterial pressure,hematocrit,AIS,ISS,and injury distribution,were prospectively collected.Independent predictive factors of ARDS following pulmonary contusion was identified using logistic regression analysis and further estimation on accuracy and value of the predictors were performed.Influence of contusion volume percentage on clinical outcomes was detected.Results Of all,mean contusion volume percentage was (22.07 ± 14.50)% (range,5.60%-61.00%),which was not strongly correlated to the admission PaO2/FiO2 ratio (R2 =0.059).ARDS and infection were diagnosed in 31 cases and 25 cases respectively.PaO2/FiO2 ratio and contusion volume percentage were independent predictive factors of ARDS after pulmonary contusion.The best cut-off of contusion percentage in predicting ARDS development was 21.5% with a specificity of 80.0%,sensitivity of 71.0%,positive predictive value of 73.3%,and negative predictive value of 78.1%.Conclusion Three-dimensional CT volume rendering technique allows quantification of pulmonary contusion and identification of patients at high risk of ARDS,to whom further treatment may be directed.%目的 探讨三维CT容积再现技术行肺挫伤容积测定对预测肺挫伤后ARDS发生和识别高危患者的价值. 方法 选取2010年7月-2011年6月急诊胸部CT检查确诊肺挫伤中胸部AIS>2分的71例患者,通过计算机软件重建肺挫伤病变范围并三维容积再现技术测定肺挫伤病变

  9. Clinical study on pulmonary circulation changes in patients with acute respiratory distress syndrome induced by lung contusion%肺挫伤致急性呼吸窘迫综合征患者肺循环变化的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨万杰; 赵雪峰; 魏凯; 冯庆国; 王伟; 刘晓智

    2012-01-01

    目的 用Swan-Ganz导管及脉搏指示连续心排血量(PiCCO)技术分析肺挫伤致急性呼吸窘迫综合征(ARDS)患者肺循环变化规律及意义.方法 采用前瞻性随机对照临床研究,选择2009年8月至2011年8月肺挫伤致ARDS患者(挫伤组,18例)和无肺挫伤且无ARdS的多发伤患者(对照组,22例),记录两组患者置管即刻及伤后12、24、36、48、60、72 h肺动脉收缩压(PAS)、肺动脉舒张压(PAD)、肺动脉楔压(PAWP)、肺动脉舒张压与肺动脉楔压梯度(PAD-PA WP)和血管外肺水指数(ELWI).比较各参数在组内和组间的差异.结果 肺挫伤致ARDS存活患者PAS、PAD和PAD-PAWP较对照组明显增高,之后逐渐回落,其中PAS、PAD于伤后60h,PAD-PAWP于伤后48 h恢复至对照组水平;而对照组PAS、PAD自置管即刻至伤后72 h无显著变化,PAD-PAWP伤后72 h较48 h增高.肺挫伤组ELWI较对照组明显升高,至12h达峰值后逐渐回落,于伤后60h恢复至对照组水平,对照组伤后60h及72 h较48 h降低.肺挫伤组PAWP开始较对照组降低,于伤后48 h恢复至对照组水平;对照组自置管即刻至伤后72 h无显著变化.相关性分析显示,挫伤组置管即刻至伤后48 h,PAS、PAD、PAD-PAWP与ELWI均呈正相关(r值分别为0.554、0.498、0.629,均P<0.01).结论 PAS、PAD、PAD-PAWP和ELWI的变化规律可指导肺挫伤致ARDS患者的液体治疗、机械通气和评估病情.%Objective To analyze the variation and significance of pulmonary circulation in patients with acute respiratory distress syndrome (ARDS) induced by lung contusion by means of Swan-Ganz catheter and the pulse index continuous cardiac output (PiCCO) monitoring.Methods A prospective,randomized,non-blinded clinical triAL was conducted.All patients admitted hospital from August 2009 to August 2011 met the inclusion criteria,were divided into the group with ARDS induced by lung contusion (contusion group,n=18 ) and the group without lung contusion and ARDS (control

  10. The value of MRI in the diagnosis of bone contusion of the knee joint%膝关节骨挫伤的MRI诊断价值

    Institute of Scientific and Technical Information of China (English)

    郑汉朋; 邱乾德

    2011-01-01

    目的:探讨MRI对膝关节骨挫伤的诊断价值.方法:搜集本院2006年1月~2010年4月间经MRI检查确诊的膝关节骨挫伤70例进行回顾性分析.70例中男45例,女25例,年龄10~69岁,平均35岁;70例行MRI检查时间自外伤后5h~20天,平均8天;70例患者外伤后局部均出现疼痛、压痛和(或)软组织肿胀及功能障碍;临床采用保守和对症治疗.结果:70例共显示134个病灶,其中股骨下端67个,胫骨上端(包括胫骨平台)54个,髌骨8个,腓骨上端5个;MRI表现为不规则斑片状或地图样T1WI低信号、T2WI等或略高信号,STIR脂肪抑制序列均呈明显高信号.伴半月板撕裂25例,侧付韧带损伤21例,前交叉韧带损伤11例.结论:MRI能揭示膝部骨挫伤的病理改变,并准确判断关节周围韧带及软组织的损伤情况,常规MRI检查并行脂肪抑制序列是诊断外伤性骨挫伤最佳的方法.%Objective: To investigate the value of MRI in the diagnosis of bone contusion of the knee joint. Methods: A retrospective analysis of 70 cases of knee bone bruise with the performance of MRI in our hospital from 2006. l to 2010. 4,including 45 males and 25 females, aged from 10 to 69 years, in averaged of 35 years old. 70 patients suffered from posttraumatic localized pain, tenderness and (or) soft swelling and dysfunction. The time interval between the accident and the MRI examination ranged from 5 h to 20 days. in averaged of 8 days. The patients with only bone contusion were treated with conservative and symptomatic treatment. Results: A total of 134 lesions in 70 cases. including 67 distal femur, 54proximal tibia (including the tibial plateau) . 8 patella, 5 fibula top* MRI showed irregular patchy or map-like in T1 WI low signal and T2 WI etc or slightly higher than the signal shadow and STIR fat suppression sequence is obvious hyperintensity,Associated with meniscal tears in 25 cases. lateral ligament injury in 21 cases . anterior cruciate ligament injury in

  11. Mangiferin attenuates contusive spinal cord injury in rats through the regulation of oxidative stress, inflammation and the Bcl‑2 and Bax pathway.

    Science.gov (United States)

    Luo, Yang; Fu, Changfeng; Wang, Zhenyu; Zhang, Zhuo; Wang, Hongxia; Liu, Yi

    2015-11-01

    Mangiferin has antioxidant, antiviral, apoptosis regulating, anti‑inflammatory, antitumor and antidiabetic effects, which can also inhibit osteoclast formation and bone resorption. However, whether mangiferin ameliorates the neurological pain of spinal cord injury (SCI) in ratS remains to be elucidated. The present study investigated the therapeutic effects of mangiferin on neurological function, the water content of spinal cord, oxidative stress, the expression of inflammatory cytokines and the protein expression of Bcl‑2/Bax in a SCI rat model. In the present study, the Basso, Beattie and Bresnahan scores, and the water content of the spinal cord were used to analyze the therapeutic effects of mangiferin on neurological pain in the SCI rat. The concentrations of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and the serum levels of glutathione peroxidase (GSH‑PX), nuclear factor‑κB p65 unit, tumor necrosis factor‑α, interleukin (IL)‑1β, IL‑6 and caspase‑3/9 were detected using commercial kits. The expression levels of Bcl‑2 and Bax were measured using western blot analysis. The results demonstrated that administrating mangiferin began to ameliorate neurological function and the water content of the spinal cord in the SCI rat. The mangiferin‑treated group were found to have lower oxidative stress activity and lower expression levels of inflammatory cytokines, compared with the SCI rat. In addition, mangiferin significantly reduced the protein expression of Bax and promoted the protein expression of Bcl-2 in the SCI rat model. Finally, mangiferin markedly suppressed the expression of caspase‑3/9, indicating that the protective action of mangiferin may be associated with anti‑apoptosis activation. In conclusion, mangiferin attenuated contusive SCI in the rats through regulating oxidative stress, inflammation and the Bcl‑2 and Bax pathway.

  12. Persistent at-level thermal hyperalgesia and tactile allodynia accompany chronic neuronal and astrocyte activation in superficial dorsal horn following mouse cervical contusion spinal cord injury.

    Science.gov (United States)

    Watson, Jaime L; Hala, Tamara J; Putatunda, Rajarshi; Sannie, Daniel; Lepore, Angelo C

    2014-01-01

    In humans, sensory abnormalities, including neuropathic pain, often result from traumatic spinal cord injury (SCI). SCI can induce cellular changes in the CNS, termed central sensitization, that alter excitability of spinal cord neurons, including those in the dorsal horn involved in pain transmission. Persistently elevated levels of neuronal activity, glial activation, and glutamatergic transmission are thought to contribute to the hyperexcitability of these dorsal horn neurons, which can lead to maladaptive circuitry, aberrant pain processing and, ultimately, chronic neuropathic pain. Here we present a mouse model of SCI-induced neuropathic pain that exhibits a persistent pain phenotype accompanied by chronic neuronal hyperexcitability and glial activation in the spinal cord dorsal horn. We generated a unilateral cervical contusion injury at the C5 or C6 level of the adult mouse spinal cord. Following injury, an increase in the number of neurons expressing ΔFosB (a marker of chronic neuronal activation), persistent astrocyte activation and proliferation (as measured by GFAP and Ki67 expression), and a decrease in the expression of the astrocyte glutamate transporter GLT1 are observed in the ipsilateral superficial dorsal horn of cervical spinal cord. These changes have previously been associated with neuronal hyperexcitability and may contribute to altered pain transmission and chronic neuropathic pain. In our model, they are accompanied by robust at-level hyperaglesia in the ipsilateral forepaw and allodynia in both forepaws that are evident within two weeks following injury and persist for at least six weeks. Furthermore, the pain phenotype occurs in the absence of alterations in forelimb grip strength, suggesting that it represents sensory and not motor abnormalities. Given the importance of transgenic mouse technology, this clinically-relevant model provides a resource that can be used to study the molecular mechanisms contributing to neuropathic pain

  13. Regulatory effects of intermittent noxious stimulation on spinal cord injury-sensitive microRNAs and their presumptive targets following spinal cord contusion.

    Science.gov (United States)

    Strickland, Eric R; Woller, Sarah A; Garraway, Sandra M; Hook, Michelle A; Grau, James W; Miranda, Rajesh C

    2014-01-01

    Uncontrollable nociceptive stimulation adversely affects recovery in spinally contused rats. Spinal cord injury (SCI) results in altered microRNA (miRNA) expression both at, and distal to the lesion site. We hypothesized that uncontrollable nociception further influences SCI-sensitive miRNAs and associated gene targets, potentially explaining the progression of maladaptive plasticity. Our data validated previously described sensitivity of miRNAs to SCI alone. Moreover, following SCI, intermittent noxious stimulation decreased expression of miR124 in dorsal spinal cord 24 h after stimulation and increased expression of miR129-2 in dorsal, and miR1 in ventral spinal cord at 7 days. We also found that brain-derived neurotrophic factor (BDNF) mRNA expression was significantly down-regulated 1 day after SCI alone, and significantly more so, after SCI followed by tailshock. Insulin-like growth factor-1 (IGF-1) mRNA expression was significantly increased at both 1 and 7 days post-SCI, and significantly more so, 7 days post-SCI with shock. MiR1 expression was positively and significantly correlated with IGF-1, but not BDNF mRNA expression. Further, stepwise linear regression analysis indicated that a significant proportion of the changes in BDNF and IGF-1 mRNA expression were explained by variance in two groups of miRNAs, implying co-regulation. Collectively, these data show that uncontrollable nociception which activates sensorimotor circuits distal to the injury site, influences SCI-miRNAs and target mRNAs within the lesion site. SCI-sensitive miRNAs may well mediate adverse consequences of uncontrolled sensorimotor activation on functional recovery. However, their sensitivity to distal sensory input also implicates these miRNAs as candidate targets for the management of SCI and neuropathic pain.

  14. PEGylated interferon-beta modulates the acute inflammatory response and recovery when combined with forced exercise following cervical spinal contusion injury.

    Science.gov (United States)

    Sandrow-Feinberg, Harra R; Zhukareva, Victoria; Santi, Lauren; Miller, Kassi; Shumsky, Jed S; Baker, Darren P; Houle, John D

    2010-06-01

    Secondary degeneration leads to an expansion of the initial tissue damage sustained during a spinal cord injury (SCI). Dampening the cellular inflammatory response that contributes to this progressive tissue damage is one possible strategy for neuroprotection after acute SCI. We initially examined whether treatment with a PEGylated form of rat interferon-beta (IFN-beta) would modulate the expression of several markers of inflammation and neuroprotection at the site of a unilateral cervical level 5 contusion injury. Adult female Sprague-Dawley rats were injured using the Infinite Horizon Impactor at a force of 200 kdyn (equivalent to a severe injury) and a mean displacement of 1600-1800 mum. A single dose (5x10(6) units) of PEGylated IFN-beta or vehicle was administered 30 min following SCI. Here we demonstrate temporal changes in pro- and anti-inflammatory cytokine levels and the expression of heat shock proteins and iNOS (involved in neuroprotection) at the lesion epicenter and one segment caudally after SCI and PEG IFN-beta treatment. The results suggested a potential therapeutic treatment strategy for modulation of secondary damage after acute SCI. Therefore, we examined whether acute treatment with PEG IFN-beta would improve forelimb function alone or when combined with forced exercise (Ex). Animals began the Ex paradigm 5 days post SCI and continued for 5 days/week over 8 weeks. Locomotion (forelimb locomotor scale [FLS], hindlimb BBB, and TreadScan) and sensorimotor function (grid walking) was tested weekly. Additional outcome measures included lesion size and glial cell reactivity. Significant FLS improvements occurred at 1 week post SCI in the PEGylated IFN-beta-treated group but not at any other time point or with any other treatment approaches. These results suggest that this acute neuroprotective treatment strategy does not translate into long term behavioral recovery even when combined with forced exercise.

  15. The Number of Circulating Fibrocytes of Skeletal Muscle in Rats after Contusion%大鼠骨骼肌挫伤后外周血源性纤维细胞的数量变化

    Institute of Scientific and Technical Information of China (English)

    李力强; 李骄勇; 于天水; 官大威; 范琰琰; 赵锐; 马文翔; 张书韬; 张舒; 任鹏

    2012-01-01

    Objection To investigate the time-dependent appearance of circulating fibrocytes of skeletal muscle in rats after contusion. Methods The model of skeletal muscle wound was established in rat. The circulating fibrocytes in contused skeletal muscle were detected by CD45 and procollagen I double im-munofluorescence staining method. Results In the control group, CD45- and procollagen I -positive cells were not detected in skeletal muscle. A few CD45 cells were observed aged from 6h to 1d after contusion. A few CD45- and procollagen I-positive cells (fibrocytes) initially gathered in injury area 3d after injury. The ratio of positive fibrocytes significantly increased 5 d after injury. The ratio of fibrocytes was highest at 7 d after contusion and then decreased. The volume of fibrocytes showed bigger with injury time increase compared with 3 d group. The expression of procollagen I and CD45 were weakened at 14 d after injury. Conclusion The circulating fibrocytes are detected in contused skeletal muscle in time-dependent pattern. Circulating fibrocytes may be a marker in the wound age determination for contused skeletal muscle.%目的 探讨大鼠骨骼肌挫伤后损伤区外周血来源的纤维细胞数量变化规律.方法 制作大鼠骨骼肌挫伤模型,应用CD45、procollagen Ⅰ双重免疫荧光染色法检测大鼠骨骼肌挫伤后各时间点外周血来源的纤维细胞的变化.结果 对照组大鼠骨骼肌中未见CD45、procollagen Ⅰ阳性的纤维细胞分布;损伤组大鼠骨骼肌挫伤后6h~1d,仅见少数CD45阳性的单个核细胞;伤后3d,开始有少量CD45、procollagen Ⅰ阳性的纤维细胞聚集于损伤区;伤后5d,阳性的纤维细胞数量明显增加;伤后7d达高峰,此后逐渐减少,同时还发现相对于3d组,纤维细胞的体积随着时间延长逐渐变大;伤后14d,纤维细胞胞质中的CD45和procollagen Ⅰ的表达强度都相应减弱.结论 大鼠骨骼肌挫伤后,挫伤区外周血来源的

  16. Chronic at-level thermal hyperalgesia following rat cervical contusion spinal cord injury is accompanied by neuronal and astrocyte activation and loss of the astrocyte glutamate transporter, GLT1, in superficial dorsal horn.

    Science.gov (United States)

    Putatunda, Rajarshi; Hala, Tamara J; Chin, Jeannie; Lepore, Angelo C

    2014-09-18

    Neuropathic pain is a form of pathological nociception that occurs in a significant portion of traumatic spinal cord injury (SCI) patients, resulting in debilitating and often long-term physical and psychological burdens. While many peripheral and central mechanisms have been implicated in neuropathic pain, central sensitization of dorsal horn spinothalamic tract (STT) neurons is a major underlying substrate. Furthermore, dysregulation of extracellular glutamate homeostasis and chronic astrocyte activation play important underlying roles in persistent hyperexcitability of these superficial dorsal horn neurons. To date, central sensitization and astrocyte changes have not been characterized in cervical SCI-induced neuropathic pain models, despite the fact that a major portion of SCI patients suffer contusion trauma to cervical spinal cord. In this study, we have characterized 2 rat models of unilateral cervical contusion SCI that behaviorally result in chronic persistence of thermal hyperalgesia in the ipsilateral forepaw. In addition, we find that STT neurons are chronically activated in both models when compared to laminectomy-only uninjured rats. Finally, persistent astrocyte activation and significantly reduced expression of the major CNS glutamate transporter, GLT1, in superficial dorsal horn astrocytes are associated with both excitability changes in STT neurons and the neuropathic pain behavioral phenotype. In conclusion, we have characterized clinically-relevant rodent models of cervical contusion-induced neuropathic pain that result in chronic activation of both STT neurons and astrocytes, as well as compromise in astrocyte glutamate transporter expression. These models can be used as important tools to further study mechanisms underlying neuropathic pain post-SCI and to test potential therapeutic interventions.

  17. Influence of Chailing Decoction on C-Reactive Protein of Pulmonary Contusion Patients%柴苓汤对肺挫伤患者C-反应蛋白的影响

    Institute of Scientific and Technical Information of China (English)

    张丽萍; 齐建永; 王旭东

    2013-01-01

    Objective: To observe the effect of Chailing Decoction on pulmonary contusion. Methods:64 cases of pulmonary contusion patients were randomly divided into two groups. 32 cases of the control group were treated by routine western medicine therapy; 32 cases in the treatment group were treated by routine treatment and oral Chailing Decoction. The level of C - reactive protein was tested before and 24,48,72h after treatment. Results:The C - reactive protein level in treatment group 24,48,72 h after treatment was lower than that in control group, P<0. 001. Conclusion:Chailing Decoction could obviously reduce the serum C -reactive protein level in early acute pulmonary contusion, and has obvious curative effect.%目的:观察柴苓汤治疗肺挫伤的临床疗效.方法:将64例肺挫伤患者随机分为两组.对照组32例,常规西医治疗;治疗组32例,在常规治疗的基础上口服柴苓汤,观察患者用药前、用药后24、48、72 h的血清C-反应蛋白水平.结果:治疗组治疗后24、48、72 h血清C-反应蛋白水平较对照组明显降低,P<0.001.结论:柴苓汤能明显降低肺挫伤患者血清C-反应蛋白水平,对急性肺挫伤早期有明显疗效.

  18. Nursing intervention of patients with severe craniocerebral injury complicated with pulmonary contusion%重型颅脑损伤合并肺挫伤患者的护理干预

    Institute of Scientific and Technical Information of China (English)

    林光霞; 李敏; 许彩云

    2013-01-01

    Objective;To explore the clinical first aid and nursing method of severe craniocerebral injury combined with pulmonary contusion, improve the cure rate. Methods:40 cases of severe head injury combined with pulmonary contusion patients were took emergency measures and nursing intervention, the nursing effect was observed. Results;ln 40 patients, 4 cases of death,13 cases of severe disability,17 cases of residual light,6 cases of of life independent, 28 patients with pulmonary infection occurred during hospitalization. Conclusion:Based on severe craniocerebral injuiy combined with pulmonary contusion in patients with active treatment and nursing intervention, effectively reduce the incidence of complications, improve the success rate of rescue, reduce the mortality and disability rate.%目的:探讨重型颅脑损伤合并肺挫伤患者的临床急救与护理方法,提高治愈率.方法:对40例重型颅脑损伤合并肺挫伤患者采取急救措施和护理干预,观察护理效果.结果:40例患者中,死亡4例,重残13例,轻残17例,生活基本自理6例.住院期间发生肺部感染28例.结论:通过对重型颅脑损伤合并肺挫伤患者实施积极抢救和护理干预,有效减少并发症的发生,提高了抢救成功率,降低了死残率.

  19. Evaluation of the Effect of early mechanical ventilation in the treatment of severe pulmonary contusion%严重肺挫伤行早期呼吸机治疗临床观察

    Institute of Scientific and Technical Information of China (English)

    周秋根; 鄢永安

    2015-01-01

    目的:评价严重肺挫伤行早期呼吸机治疗的效果。方法回顾2009年10月-2014年12月严重肺挫伤患者87例,行呼吸机治疗24 h后分析血气指标的变化。结果行呼吸机治疗24 h后动脉血氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)、呼吸和心率均较前有明显改善(P<0.05)。部分患者避免了手术内固定治疗。本组治愈76例,治愈率87.4%。结论尽早对严重肺挫伤患者行呼吸机治疗能明显改善病情。%Objective To evaluate the effect of early mechanical ventilation on the treatment of severe pulmonary contusion.Methods 87 cases of severe pulmonary contusion from October 2009 to December 2014 were retrospectively analyzed-the changes of all kinds of parameters after 24 h mechanical ventilation treatment were analysed. Results PaO2,PaCO2,PaO2/FiO2,R and HR were obviously improved after the treatment,and there was statistical significance (P<0.05);Part of the patients avoided internal fixation operation.76 cases were cured. The cure rate was 87.4%. Conclusion Early mechanical ventilation could obviously improve patientg conditions in treating severe pulmonary contusion.

  20. 64层螺旋CT在急性肺挫伤诊断中的应用价值%The Value of Applying 64 Multi-slice CT(MSCT) to the Diagnosis of Acute Pulmonary Contusion

    Institute of Scientific and Technical Information of China (English)

    殷国生; 张树桐

    2012-01-01

    目的:探讨64层螺旋CT在急性肺挫伤诊断中的应用价值。方法:收集临床怀疑肺挫伤患者461例,所有患者于入院后1 h内行64层螺旋CT胸部平扫,判断有无肺挫伤。结果:诊断肺挫伤113例,双肺广泛性挫伤12例,右肺挫伤61例,左肺挫伤40例;肺不张22例;合并气胸33例,其中血气胸10例;肋骨骨折38例,锁骨骨折4例,肩胛骨骨折2例,胸椎骨折2例,胸骨骨折1例;皮下气肿87例,纵膈积气11例,纵膈血肿3例。结论:64层螺旋CT能有效诊断肺挫伤,尤其对影像学征象较隐蔽的病变更具优势。%Objective: To explore the clinical application of 64-MS CT to acute pulmonary contusion.Methods: A retrospective study was undertaken in 461 cases who were doubted acute pulmonary clinically.They were received CT scan within one hour.Results: 113 cases were diagnosed acute pulmonay contusion including 12 cases with wide-bound pulmonary contusion in pulmones,61 cases with right lung,40 cases with left lung,22 cases with pulmonary atelectasis,33 cases with aeropleura,10 cases with hemopneumothorax,38 cases with fracture of rib,4 cases with fracture of clavicle,2 cases with fracture of shoulder blade,2 cases with thoracic vertebral fracture,1 case with fracture of sternum,87 cases with pneumoderma,11 cases with mediastinal emphesema and 3 cases with mediastinal hematoma.Conclusion: 64-MSCT can effectively diagnose acute pulmonary contusion,especially in diagnosing the larvaceous imaging signs.

  1. Significance of serum CD62p level in patients with severe pulmonary contusion%早期重度肺挫伤患者测定P选择素的临床意义

    Institute of Scientific and Technical Information of China (English)

    麻成方; 李志华; 魏春勇; 汪礼旭; 罗艺; 洪琼川

    2009-01-01

    目的 探讨早期重度肺挫伤患者血浆(CD62p) 的水平与病情严重程度、预后的相关性.方法 45例重度肺挫伤患者在外伤后2 h、12 h、24 h、3 d、7 d测定血浆CD62p, 并根据预后分为生存组和死亡组.设轻度肺挫伤患者为对照组.结果 重度肺挫伤患者的CD62p水平在伤后12 h、24 h、3 d比伤后2 h时有明显的升高(P<0.05).在外伤后的2 h、12 h,生存组与死亡组患者的CD62p水平与对照组比较,差异有统计学意义(P<0.05).而且,死亡组的CD62p水平比生存组明显升高(P<0.05).结论 血小板活化程度与重度肺挫伤患者的病情严重程度及其预后相关.%Objective To determine the changes of patients with severe pulmonary contusion and the relationship among the serum level of alpha-granular membrane protein (CD62p), the severity of injury and prognosis. Methods The serum level of CD62p, was measured in 45 patients with severe pulmonary contusion on hour 2, hour 12,day 1,3,7 after injured. Forty-five patients were divided into two groups: the survive group and the death group. The levels of CD62p between two groups were compared. Results The serum levels of CD62p in patients with severe pulmonary contusion on 12 hours, 1,3 days after injury were higher than those on 2 hours (P<0.05). The serum levels of CD62p in the survive group and death group on 2 h, 12 hours after injury were higher than those in the control group(P<0.05), and the serum levels of CD62p in the death group were higher than those in the survive group. Conclusion It was helpful in judging the severity of head in jury and prognosis to determine the serum levels of CD62p in patients with severe pulmonary contusion.

  2. Diagnosis of pulmonary contusion by CT scan for patients with volume efficiency of pulmonary blood%肺血容积效应合并肺挫裂伤的CT诊断分析

    Institute of Scientific and Technical Information of China (English)

    曹结水; 张新民

    2014-01-01

    Objective:To explore characteristics of pulmonary contusion by CT scan for patients with volume effi-ciency of pulmonary blood. Methods:A serial of 46 patients with thoracic trauma who were found with high dense im-age by supine CT scan were scanned again in the lateral prone position. CT findings were compared between the supine position and the lateral prone position. Results:Among 46 patients with thoracic trauma, pulmonary contusion was diagnosed in 12 patients by CT scan in the supine position and 26 patients in the lateral prone position. The posi-tive rate of pulmonary contusion by CT scan was significantly higher in the lateral prone position than that in the supine position group (P<0.05). Conclusions:CT scan in the lateral prone position is superior to that in the supine po-sition for diagnosis of pulmonary contusion in patients with thoracic trauma.%目的:探讨肺血容积效应合并肺挫裂伤的CT表现。方法:对46例胸部外伤仰卧位平扫见肺部背侧高密度影患者,再行侧卧位或俯卧位扫描,分析肺血容积效应合并肺挫裂伤的CT特征。结果:46例肺血容积效应患者中仰卧位发现12例合并肺挫裂伤,侧、俯卧扫描患者中发现26例合并肺挫裂伤,差异具有统计学意义(P<0.05)。结论:侧、俯卧位扫描在肺血容积效应合并肺挫裂伤中有诊断意义,避免误诊和漏诊。

  3. Expression of aquaporin 1 and 4 in lung tissue of rats with contusion injury%水通道蛋白1和4在大鼠挫伤肺组织中的表达

    Institute of Scientific and Technical Information of China (English)

    孙相华; 洪文娟; 洪志鹏; 周菊; 祝艳翠

    2014-01-01

    目的:探讨水通道蛋白(AQP)1和4在老年大鼠挫伤后肺组织中的表达。方法通过自由落体模型制作老年鼠肺挫伤模型,分别于伤后1,3和6 h处死,取右侧肺上叶组织测水含量,RT-PCR法测量AQP1和4的mRNA表达,Western印迹法检测蛋白AQP1和4的表达水平。结果伤后老年大鼠的肺组织水含量比明显增加,与假手术组相比,AQP1和4的mRNA和蛋白表达在术后逐渐升高,术后6 h有显著差异(P<0.05), AQP-1的蛋白表达量亦明显升高( P<0.05)。结论 AQP1和4在挫伤后的肺组织中表达升高,靶向调节二者的表达可能对于肺挫伤后肺水肿的治疗具有重要意义。%Objective To investigate the expression of aquaporin ( AQP) 1 and 4 in lung tissues of aged rats with contusion injury . Methods The aged rat pulmonary contusion model was made by free falling body method .The rats were killed after injury for 1, 3 and 6 h. Their right upper lobe of lung tissues were took out to measure the water content .The expression of mRNA of AQP 1 and 4 were measured by PT-PCR.And the expression level of protein of AQP 1 and 4 were measured by Western blot .Results After injury, the water content in aged rats’ pulmonary tissues increased significantly .Compared with the control group , the expression of mRNA and protein of AQP 1 and 4 increased gradually after operation.And after 6 h, the differences showed statistical significance (P<0.05), as well the expression level of protein of AQP1.Conclusions The expression of AQP4 and 1 in contused lung tissue could increase significantly .Targeted adjustment might have important significance for the treatment of pulmonary edema after lung contusion .

  4. 肺挫伤后肺特异性相关蛋白血清 CC16变化的临床研究%Clinical study on the changes of lung specific protein-CC16 after lung contusion

    Institute of Scientific and Technical Information of China (English)

    闻梦妮; 赵钢; 张佳胤; 赵永红

    2014-01-01

    目的:探讨血清肺特异性相关蛋白克拉拉蛋白16( CC16)浓度的连续监测对诊断肺挫伤、评估其严重程度及预判疾病进展的临床价值。方法选择经胸部CT确诊有肺挫伤的急性创伤患者31例,分别于伤后第3、5、7天复查胸部CT,应用体积计算程序得出肺挫伤体积,同时观察记录肺不张、胸腔积液等相关并发情况。所有患者连续7 d采集血标本测定血清CC16浓度。另取15名健康志愿者血标本检测值作为正常参考值。进一步对血清CC16浓度与肺挫伤体积及其变化程度做相关分析。结果所有肺挫伤患者血清CC16浓度均明显高于正常参考值,且在首日即达峰值。 CT显示,肺挫伤受损范围会逐渐增大并有肺不张和胸腔积液相关并发症发生。病程中最大肺挫伤体积与7 d内血清CC 16浓度均值和初始血清CC16浓度均呈正相关关系,肺挫伤体积的变化程度与初始CC16浓度存在正相关关系。结论创伤后血清CC 16浓度的升高对诊断肺挫伤有参考价值,高水平的CC16浓度预示着挫伤程度严重并有进一步进展的可能,血清CC16浓度监测可为临床决策提供依据。%Objective To explore the clinical value of continuously monitoring serum CC 16 levels in diagnosing pulmonary contusion , estimating its severity degree and predicting disease progression.Methods Thirty -one acute trauma patients with lung contusion diagnosed by chest computed tomography were included , and reexamined chest CT on day 3, 5 and 7 after injury.Total contusion volume was calculated by the Siemens syngo volume calculation program .Complications like pleural effusion or atelectasis were observed and recorded .Enzyme-linked immunoassay ( ELISA) was employed for measuring the levels of CC 16 in all patients for seven days , another 15 serum were taken from healthy volunteers to provide the reference value .Correlation analysis was further conducted for the CC

  5. 血必净治疗严重肺挫伤效果分析%Efficacy analysis of the treatment of Xuebijing in the severe pulmonary contusion patients

    Institute of Scientific and Technical Information of China (English)

    庄育田; 白士先; 孙继玲; 马云; 董娜

    2013-01-01

    Objective To investigate the effects of Xuebijing on the regulations of tumor necrosis factor-α(TNF-α) 、von Wilebrand factor(vWF)、interleukin-6 (IL-6) and the treatment effectiveness in pulmonary contusion patients.Methods Fifty-one pulmonary contusion patients admitted into the hospital from January 2010 to January 2012 were enrolled in the study and were randomly divided into two groups (treatment group and control group).The levels of the TNF-α、vWF 、IL-6 in the pulmonary contusion patients were measured by enzyme linked immunosorbent assay to investigate the change of the inflammatory cytokines and the treatment effectiveness in treatment group and control group.Results The hospitalization time of treatment group and control group was (19.83 ± 2.35) d,(21.52 ± 2.73) d respectively,the hospitalization time of the treatment group was significantly shorter than the control group,the difference was statistically significant (t =2.38,P <0.05) ;The incidence of ARDS was 14.81% and 41.67% respectively,the incidence of ARDS of the treatment group was significantly lower,the difference was statistically significant (x2 =4.6,P < 0.05) ;The inflammatory mediators index of the two groups showed as follws:the first day of the TNF-α(181.35 ± 14.25) ng/L,(179.17 ± 16.28) ng/L,the third day of the TNF-α(169.21 ± 16.42) ng/L,(179.18 ± 17.31) ng/L,the fifth day of the TNF-α(131.78 ± 13.02) ng/L,(140.84 ± 14.27) ng/L,the seventh day of the TNF-α (99.45 ± 16.02)ng/L,(110.56 ± 17.09) ng/L;The first day of the vWF (178.73 ± 22.09) ng/L,(177.73 ± 23.02) ng/L,the third day of the vWF (208.46 ± 14.13) ng/L,(220.53 ± 23.02) ng/L,the fifth day of the vWF (252.32 ±15.22) ng/L,(266.40 ±25.79) ng/L,the seventh day of the vWF(201.49 ±9.21) ng/L,(217.27 ±22.68)ng/L;The first day of the IL-6 (172.14 ± 12.41) ng/L,(169.53 ± 13.55) ng/L,the third day of the IL-6 (147.24 ± 16.33) ng/L,(158.41 ±21.04) ng/L,the fifth day of the IL-6(126.36 ± 11.37) ng

  6. Experience of mucosolvan in treatment of patients with pulmonary contusion%沐舒坦治疗肺挫伤患者的体会

    Institute of Scientific and Technical Information of China (English)

    尹婷; 姚碧辉

    2014-01-01

    目的:观察沐舒坦在肺挫伤病人治疗中的临床应用价值。方法82例患者根据是否使用沐舒坦治疗将其分为两组,沐舒坦:41例,治疗过程中用沐舒坦治疗;对照组:41例,治疗过程中不使用沐舒坦治疗。对两组患者的痰量、痰性质、痰鸣音症状进行观察。结果治疗组患者的痰量、痰性质、痰鸣音症状有了显著的改善,并且肺部并发症(肺不张)的发生率低于对照组。结论应用沐舒坦治疗能够使咳嗽咳痰症状显著得到改善,预防并发症的发生,促进患者的康复。%Objective to observe the effect of ambroxol in the treatment of pulmonary contusion patients in clinical application value. Methods 82 cases of patients according to whether using Mucosolvan treatment will be divided into two groups: 41 cases with, ambroxol, Mucosolvan treatment process; control group: 41 cases, do not use Mucosolvan treatment process. the quantity of sputum, two groups of patients with phlegm, phlegm sound nature of symptoms were observed.Results the sputum volume, the patients in the treatment group were sputum, phlegm sound nature of symptoms was significantly improved, and pulmonary complications (atelectasis) incidence rate lower than that of control group. Conclusion the application of ambroxol treatment can make the symptoms of cough and expectoration were improved, prevent the happening of complication, promote the rehabilitation of patients.

  7. Beneficial effects of modest systemic hypothermia on locomotor function and histopathological damage following contusion-induced spinal cord injury in rats.

    Science.gov (United States)

    Yu, C G; Jimenez, O; Marcillo, A E; Weider, B; Bangerter, K; Dietrich, W D; Castro, S; Yezierski, R P

    2000-07-01

    Local spinal cord cooling (LSCC) is associated with beneficial effects when applied following ischemic or traumatic spinal cord injury (SCI). However, the clinical application of LSCC is associated with many technical difficulties such as the requirement of special cooling devices, emergency surgery, and complicated postoperative management. If hypothermia is to be considered for future application in the treatment of SCI, alternative approaches must be developed. The objectives of the present study were to evaluate 1) the relationship between systemic and epidural temperature after SCI; 2) the effects of modest systemic hypothermia on histopathological damage at 7 and 44 days post-SCI; and 3) the effects of modest systemic hypothermia on locomotor outcome at 44 days post-SCI. A spinal cord contusion (12.5 mm at T-10) was produced in adult rats that had been randomly divided into two groups. Group 1 rats (seven in Experiment 1; 12 in Experiment 2) received hypothermic treatment (epidural temperature 32-33 degrees C) 30 minutes postinjury for 4 hours; Group 2 rats (nine in Experiment 1; eight in Experiment 2) received normothermic treatment (epidural temperature 37 degrees C) 30 minutes postinjury for 4 hours. Blood pressure, blood gas levels, and temperatures (epidural and rectal) were monitored throughout the 4-hour treatment period. Twice weekly assessment of locomotor function was performed over a 6-week survival period by using the Basso-Beattie-Bresnahan locomotor rating scale. Seven (Experiment 1) and 44 (Experiment 2) days after injury, animals were killed, perfused, and their spinal cords were serially sectioned. The area of tissue damage was quantitatively analyzed from 16 longitudinal sections selected from the central core of the spinal cord. The results showed that 1) modest changes in the epidural temperature of the spinal cord can be produced using systemic hypothermia; 2) modest systemic hypothermia (32-33 degrees C) significantly protects against

  8. The expression of NT-proBNP in acute pulmonary contusion patients%急性肺挫伤患者N末端B型钠尿肽前体的动态变化及其意义

    Institute of Scientific and Technical Information of China (English)

    周继光; 李起栋; 洪钰锟; 许月红

    2013-01-01

    Objective To study the clinical changes of N-terminal pro-brain natriuretie peptide(NT-proBNP) in patients with acute pulmonary contusion. Methods 263 patients with acute pulmonary contusion were divided into three different classifications for the sake of comparison in different respects, namely (1)acute pulmonary contusion with ARDS group and acute pulmonary contusion without ARDS group, (2)survival group and non-survival group, and (3)ISS score<20 group and ISS score≥20 group. The levels of serum NT-proBNP were respectively detected by electrochemical luminescence assay(ECLIA) within 24 hours of injury and 3, 5 and 7 days after injury. The regularity of their changes was observed and the correlation factors were analyzed from the data. Results Compared with normal, the levels of serum NT-proBNP were significantly increased in patients with acute pulmonary contusion in all intervals of detection, The levels of serum NT-proBNP was positively correlated with ISS score.The levels of serum NT-proBNP escalated gradually in acute pulmonary contusion with ARDS, and reached significantly higher levels in 5 days and 7 days after injury compared with those without ARDS group (P<0.05). The levels of serum NT-proBNP were higher in nou-survival group than those in survival group(P<0.05). The increase in levels of serum NT-proBNP peaked and then declined in 5 days in ISS score≥20 group, whereas it peaked and declined in 3 days after injury in ISS score<20 group. Conclusions The levels of serum NT-proBNP were increased in patients with severe pulmonary contusion, It was positively correlated with ISS score, reflecting the severity of pulmonary injury(r=0.606, P<0.05). The levels of serum NT-proBNP were the sensitive markers for evaluating the severity of pulmonary injury and the prognosis of ARDS caused by severe pulmonary contusion.%目的:通过检测急性肺挫伤患者血中 N 末端 B 型钠尿肽前体(NT-proBNP)在受伤后不同时间点的水平,揭示其

  9. 血府逐瘀汤对急性肺挫伤后炎性因子影响的临床研究%Clinical study of Xuefu Zuyu Decocotion on inflammatory factors in Patients with Acute Pulmonary Contusion

    Institute of Scientific and Technical Information of China (English)

    詹锋; 姜镭; 李栋

    2011-01-01

    目的 观察血府逐瘀汤对急性肺挫伤患者血清肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)的影响.方法 选择60例肺挫伤患者,随机分为对照组和治疗组各30例.两组均给予吸氧、雾化吸入、止血、抗感染、营养、药物外敷等常规治疗,治疗组在此基础上加用血府逐瘀汤(由桃仁、红花、当归、生地、赤芍、川芎、柴胡、枳壳、桔梗、牛膝、甘草等11味药组成)治疗,对照组则加用曲马多缓释片口服治疗,两组疗程均为1周.观察肺挫伤后继发性肺损伤情况和患者康复时间,记录并比较各组动脉血气分析结果;血清TNF-α、IL-6水平变化情况.结果 治疗组患者的血清TNF-α、IL-6水平较对照组有明显的降低(P<0.05),康复时间显著缩短(P<0.05).在继发性肺损伤方面,治疗组无出现肺部感染和急性呼吸窘迫综合征(ARDS);对照组2例发生肺部感染,1例出现ARDS.结论 血府逐瘀汤能显著降低患者TNF-α、IL-6水平,阻断肺损伤的演变进程,缩短康复时间,表明血府逐瘀汤对肺挫伤有明显的治疗作用.%Objective To investigate the effect of Xuefu Zuyu Decoction on serum inflammatory cytokines of tumor necrosis factor (TNF) -α and interleukin -6 ( IL-6) in acute pulmonary contusion patients. Methods Sixty acute pulmonary contusion patients were equally randomized into the control group (receiving routine medical treatment and use of Tramadol) and the treatment group (receiving routine medical treatment and use of Xuefu Zuyu Decocotion). The treatment lasted for 1 week. Secondary pulmonary contusion, recovery time and the serum levels of TNF - a and IL-6 were observed. Results Serum levels of TNF - ot and IL - 6 in the treatment group were decreased (P <0.01) ,and the recovery time was shortened as compared with those in the control group (P <0.01). In the treatment group, there was no patient with acute respiratory disease syndrome ( ARDS) while one in the

  10. Flail chest and pulmonary contusion.

    Science.gov (United States)

    Bastos, Renata; Calhoon, John H; Baisden, Clinton E

    2008-01-01

    Flail chest is most often accompanied by a significant underlying pulmonary parenchymal injury and can be a life-threatening thoracic injury. Its management is often complicated by the other injuries it is frequently associated with. Similarly, mortality and morbidity are dictated most often by the associated injuries and findings. Its treatment is complex and should first be one of pain management, judicious fluid resuscitation, and excellent pulmonary toilet. In those patients requiring mechanical ventilatory support, or who require ipsilateral thoracocotomy, rib stabilization may be considered depending on a host of potentially conflicting indications and contraindications. At the end of this section are listed the current major recommendations and their levels of evidence.

  11. The Impact of Acupuncture on Muscle Regeneration in Rat Skeletal Muscle Contusion%针刺对大鼠骨骼肌挫伤后肌肉再生的影响

    Institute of Scientific and Technical Information of China (English)

    李俊华; 王正珍; 唐云峰; 王军力

    2012-01-01

    目的:观察针刺对SD大鼠骨骼肌钝挫伤后肌肉再生的影响。方法:将采用打击装置造成后下肢腓肠肌钝挫伤的大鼠随机分为即刻组、针刺治疗组、自然愈合组。针刺治疗组采用阿是穴针刺疗法,自然愈合组不治疗。结果:针刺能促使炎症反应早期出现和及时消退,从而加速坏死组织的清除,并更好地激活肌肉再生过程。大鼠骨骼肌挫伤后,针刺能促进肌卫星细胞的增殖并促使活跃期提前出现,促进肌肉再生。结论:针刺能促进大鼠急性骨骼肌钝挫伤后肌肉再生,加速组织愈合的进程并提高愈合质量。%Objective: The purpose is to observe the effect of acupuncture on muscle regeneration after SD rat skele- tal muscle contusion. Method: In this research, the device was used to combat the rat's lower limb gastrocnemius after muscle contusion. And the rats were divided into blunt immediate group,acupuncture group and the natural healing group. The treatment group was treated with Ashi point acupuncture therapy. Result: The results showed that acupuncture could induce inflammatory reaction occurs early and timely dissipated, thereby accelerat- ed the removal of necrotic tissue,and had a better activation of muscle regeneration process. After the damage of the rat's skeletal muscle, acupuncture could promote muscle satellite cell proliferation and induce active early e- mergence, contribute to muscle regeneration. Conclusion: acupuncture could promote muscle regeneration after the rat acute skeletal muscle contusion, accelerate tissue healing process and improve the healing quality.

  12. The clinical application value of CT reexamination in the patients with occult pulmonary contusion%CT复查在首诊为隐匿性肺挫伤患者中的应用价值

    Institute of Scientific and Technical Information of China (English)

    向前; 王凌; 孔德会; 李全

    2014-01-01

    目的:评价多层螺旋CT(MSCT)在隐匿性肺挫伤(OPC)患者随访复查中的临床价值。方法对35例首诊确定为OPC患者的CT随访资料及临床转归进行回顾性分析,观察CT图像上肺挫伤病变的范围、密度演变情况,患者合并感染及临床转归情况,判断CT复查在OPC患者中的应用价值。结果所有35例OPC患者均在伤后1~90 d内进行1~4次CT复查,其中13例患者出现挫伤范围的扩大,主要出现在伤后1~2 d;7例继发肺炎,主要出现在伤后7~14 d,1例发展为急性呼吸窘迫综合征(ARDS),1例患者继发脓胸。结论首诊为OPC的患者病情可能继续发展,MSCT能较全面地判断评价OPC患者肺部病变的演变情况,应当作为OPC患者重要的随访复查手段。%Objective To evaluate the clinical application value of multi-slice spiral CT (MSCT) reexamination in the patients with occult pulmonary contusion (OPC). Methods The CT and clinical data of 35 patients with OPC was retrospectively analyzed. Analyze the scopes and densities of contusions, contusions′ variation with time and pa-tients clinical prognosis in order to evaluate the clinical application value of MSCT reexamination in the patients with OPC. Results CT reexamination was performed in 1-90 days after injury. The scope of pulmonary in 13 patients contusion enlarged,which appeared mainly in 1-2 days after injury. Pneumonia was found in 7 patients, which mainly appeared in 7-14 days after injury. One case developed to acute respiratory distress syndrome (ARDS), and one pa-tients developed to empyema. Conclusion The condition of OPC may aggravate. MSCT could comprehensively evalu-ate the changes of OPC, which should be a good choice for follow-up examination of patients with OPC.

  13. 参附注射液对兔肺挫伤治疗作用的实验研究%Effect of Shen-fu injection on pulmonary contusion rabbits

    Institute of Scientific and Technical Information of China (English)

    朱红军; 于曙东; 何靖康; 陆士奇

    2009-01-01

    Objective To investigate the effects of Shen-fu injection on pulmonary contusion rabbits. Meth-ods Sixteen rabbits were randomly divided into 2 groups: the treatment group (Shen-fu group) and the control group. The animals were induced the pulmonary contusion models. After 60min, the animals in Shen-fu group re-ceived Shen-fu injection received 5 ml/kg, and those in control group 5 ml/kg LRS. The animals were killed six hours later, the right lung tissue wet-to-dry (W/D) ratio and myeloperoxidase (MPO) activity were obtained,the pro-tein expression of nuclear factor-kappa B (NF-κB) and intercellular adhesion molecule-1 (ICAM-1) were also detec-ted. Results The lung tissue W/D, MPO, and the protein expression of NF-κB and ICAM-1 were decreased evi-dently in Shen-fu group (P<0. 01). The morphologic and ultrastructural damages in Shen-fu group were milder than in control group. Conclusion Shen-fu injection is effective on pulmonary contusion rabbits.%目的 研究参附注射液对兔肺挫伤的治疗效果及可能机制.方法 新西兰白兔16只随机分为两组:参附(应用参附注射液)组和对照组各8只.制作肺挫伤模型,60 min后分别应用参附注射液和林格液治疗.在6 h后将动物处死,取右肺检测其干湿比(W/D),测定肺组织中髓过氧化物酶(MPO)活性、核转录因子(NF-κB)的表达以及细胞间黏附分子-1(ICAM-1)的表达,并观察肺组织病理结构的变化.结果 参附组W/D和MPO明显低于对照组(P<0.01),肺组织中NF-κB和ICAM-1的表达也明显低于对照组(P<0.01),肺组织病理变化较对照组轻.结论 参附注射液对肺损伤有较好的治疗作用.

  14. Extravascular lung water index monitoring and fluid management in patients with pulmonary contusion%肺挫伤患者血管外肺水指数的监测和液体管理

    Institute of Scientific and Technical Information of China (English)

    彭民; 宋世辉; 周文; 张鹏

    2012-01-01

    Objective To guide fluid management and evaluate the clinical index through monitoring extravascular lung water index(EVLWI) of patients with pulmonary contusion.Methods Thirtyone severe chest trauma patients with pulmonary contusion were selected,performed with central venous catheterization or femoral artery catheterization,and connected to pulse index continuous cardiac output (PICCO).EVLWI after pulmonary contusion were measured by using thermal dilution.The intake and output of patients were recorded in detail,fluid intake was controlled,furosemide was prescribed,and the changes and correlations of oxygenation index,EVLWI and liquid balance difference at different time points were evaluated.Results EVLWI after pulmonary contusion at 1st to 7th d after hospitalization was respectively (9.25 ±0.71),(8.98 ±0.61),(8.61 ±0.59),(7.75±0.53),(6.64 ±0.49),(6.22±0.36),(5.59 ±0.39) ml/kg.Comparing with 1st d after hospitalization,EVLWI declined from 3rd d (P < 0.05).Oxygenation index at Ist to 7th d after hospitallzation was respectively( 145.76±23.61 ),( 144.19±20.24),( 146.67±19.25 ),(159.33±15.42),(177.38±14.25),(199.33±19.04),(213.71±18.51) mm Hg(1 mm Hg =0.133 kPa).Comparing with 1st d,oxygenation index from 4th to 7th d had significant difference (P < 0.05 ).The fluid volume at 1st d to 7th d were all negative balance,that of 3rd d to 6th d had significant difference comparing with 1st d [(-431.43±121.17),(-601.43±127.09),(-629.52±140.69),(-320.01 ±93.71) ml vs.(-213.81±63.91 ) ml](P < 0.05 ).Oxygenation index and EVLWI had negative correlation(r =-0.824,P<0.01).Liquid balance difference and the changes of oxygenation index and EVLWI had no correlation.Conclusion EVLWI effectively monitoring after pulmonary contusion can not only evaluate the changes of pulmonary vascular permeability of patients with pulmonary contusion,but also have important significance to guide fluid management.%目的 通过对肺挫伤患者血管外肺水指

  15. Effect of nuclear factor-kappa B decoy oligodeoxynncleotides on respiratory function and cytokine expression after severe lung contusion in rabbits%NF-kB双链寡脱氧核苷酸圈套对严重肺挫伤兔呼吸功能及炎性因子表达的影响

    Institute of Scientific and Technical Information of China (English)

    方丹青; 于涛; 万丽

    2010-01-01

    Objective To explore the effect of nuclear factor-kappa B (NF-κB) decoy oligode-oxynucleotides (ODN) on respiratory function and expressions of IL-1β and IL-13 in serum following se-vere lung contusion in rabbits. Methods A total of 40 New-Zealand rabbits were randomly divided into four groups, ie, severe lung contusion group (Group A, n=12), severe lung contusion with NF-κB scrambled decoy ODN intervention group (Group B, n=12), severe lung contusion with sense NF- B de-coy ODN intervention group (Group C, n=12) and normal control group (Group D, n =4). After the contusion model was set up, the sense and scrambled NF-κB decoy ODN were infused into the rabbits via the jugular veins in different groups, with 20 g per experimental rabbit. After contusion, respiratory fre-quency, tidal volume, airway pressure, respiration flow rate curve and end expiration nitric oxide concen-tration were detected at 1, 2, 3 and 4 hours. The expressions of IL-1β and IL-13 in serum were observed by means of ELISA. Results After sense NF-κB decoy ODN intervention, alveolar ventilation, arteri-al PO_2 and pulmonary compliance were improved, compared with Group A and Group B, with statistical difference (P0.01).血清炎性因子IL-1β在挫伤后1 h升至高峰,并持续至实验结束,IL-13的表达在肺挫伤后1 h下降,4 h降至最低值.经正链decoy ODN治疗后可使挫伤后显著升高的IL-1β明显降低,而IL-13的表达维持于高水平,与挫伤组、杂链组比较,差异有统计学意义(P<0.01).结论 在严重胸外伤肺挫伤早期呼吸功能出现损害时给予NF-κB正链decoy ODN治疗,对挫伤肺通气功能、换气功能、呼吸力学有明显的保护作用,且血清炎性因子IL-1β的表达减少,IL-13表达升高.

  16. 老年人额叶挫裂伤病情进展恶化的危险因素分析%Analysis of the related risk factors for progress of the elderly frontal lobe contusions

    Institute of Scientific and Technical Information of China (English)

    周世聪; 贾强; 周贤文; 王宗宝; 潘增军

    2016-01-01

    Objective To investigate the related risk factors for progress of the elderly frontal lobe contusions. Methods The clinical data of 118 cases of elderly frontal lobe contusions from August 2012 to August 2014 were retrospectivelyanalyzed.118 patients were given conventional therapy after admission,received dynamic review of brain CT.The progress of patients were performed surgery of frontal coronary approach,removed contusion brain tissue by bone flap of single frontal or double the frontal lobe.No progress of patients were given conventional conservative treat-ment.Selected seven indicators combining with hypertension,oral aspirin,diabetes mellitus,contrecoup injury,Cushing response,sylvian cistern exist or not and subdural hematoma did a statistical analysis.Results This group of 118 patients,68 cases (57.6%)had progress and 50 cases (42.4%)had no progress.Statistical analysis showed that oral aspirin (P =0.006 ),sylvian cistern exist or not (P =0.001 ),Cushing response (P =0.025 )were independent risk factors of progress of the elderly frontal lobe contusions.Conclusion For elderly patients with fron-tal lobe contusion,oral aspirin,sylvian cistern exist or not,whether there is any Cushing response were risk factors for deterioration of disease progression.If one or more risk factors appeared,clinical need to prevent disease progression.%目的:探讨老年人额叶挫裂伤病情进展恶化的相关危险因素。方法回顾性分析滨州市中心医院神经外科2012年8月至2014年8月收治的额叶挫裂伤患者235例(其中老年人额叶挫裂伤118例)的临床资料。118例患者入院后给予常规治疗,并动态复查脑 CT。病情进展患者常规行冠状入路、单额或者双额骨瓣行挫伤脑组织清除术;病情未进展患者继续行常规保守治疗方案。选取患者合并高血压、口服阿司匹林、合并糖尿病、对冲伤、库欣反应、侧裂池是否存在及合并硬膜下血肿共7个指标进行

  17. 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

    Directory of Open Access Journals (Sweden)

    Thiago Domingos Corrêa

    2007-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A contusão miocárdica está freqüentemente associada ao trauma torácico fechado. Seu correto diagnóstico é um constante desafio aos profissionais que trabalham em unidades de emergência, devido aos seus sintomas inespecíficos e a ausência de exames subsidiários com precisão para fazer o diagnóstico. Dentre os diversos métodos diagnósticos estudados, tem-se destacado nos últimos anos o papel dos indicadores de necrose miocárdica troponina I e troponina T. Por serem proteí­nas constituintes do aparelho de regulação contrátil celular, são liberadas na corrente sanguínea somente após a perda da integridade de membrana dos miócitos e, portanto, são altamente específicas para detectar lesão miocárdica. CONTEUDO: Foi realizada uma revisão de estudos clínicos nas bases eletrônicas de dados MedLine e LILACS, no período de janeiro de 1980 a novembro de 2006, sobre a importância da dosagem seriada de troponina como instrumento diagnóstico e preditor de evolução clínica desfavorável nos pacientes com contusão miocárdica. CONCLUSÕES: Embora exista maior especificidade das troponinas I e T quando comparadas aos indicadores tradicionais, CKMB massa e CPK total, esses dois indicadores apresentarem sensibilidade e valor preditivo positivo baixos para diagnosticar contusão miocárdica. Pacientes que apresentam alterações eletrocardiográficas, elevação de troponinas, ou ambas, devem permanecer em observação em unidade de terapia intensiva (UTI, por no mínimo 24 horas, período em que se desenvolve a maioria das complicações decorrentes da contusão miocárdica.BACKGROUND AND OBJECTIVES: Myocardial contusion is often associated with blunt chest trauma. Its diagnosis is challenging to the professionals who work in emergency department due to nonspecific symptoms and the lack of auxiliary exams with enough accuracy to diagnose. Among the available diagnostic tools, the biomarkers of

  18. Effects of infusion restriction on pulmonary contusion with hemorrhagic shock%限制性补液对肺挫伤伴失血性休克的影响

    Institute of Scientific and Technical Information of China (English)

    麦惠强; 蒋崇慧; 郑超群

    2010-01-01

    Objective To explore the effect of infusion restriction on pulmonary contusion with hemorrhagic shock.Methods Seventy-eight patients (ISS≥25) with pulmonary contusion and hemorrhagic shock who had been hospitalized from January 2008 to March 2010 were included in this study.All the patients required mechanical ventilation and fluid rescue because of severe hypoxia and shock and were randomly divided into conventional group (n = 38) and restriction group (n = 40).FT,APTT,BE,lactic acid content,PO2,PO2/FiO2,and changes in chest radiology were determined; ventilation time,length of ICU stay,the motality,incidence,and curative rate of ARDS or MODS were studied in the two groups.Results FT,APTT,BE,and lactic acid content were lower in both restriction group and convertional group.As compared with conventional group,PO2,PO2/FiO2,and pulmonary inflammatory absorption were elevated (P<0.05),ventilation time and length of ICU stay were shortened,the mortality and incidence of ARDS or MODS were reduced (P<0.05),and the curative rate was increased in restriction group (P<0.05).Conclusions Infusion restriction in the treatment of pulmonary contusion with hemorrhagic shock can effectively improve coagulopathy and relieve acidosis and it markedly promotes pulmonary repair and increases the survival rate and the prognosis.%目的 观察限制性补液对肺挫伤伴失血性休克病人的治疗效果.方法 将2008年1月-2010年3月共救治肺挫伤伴失血性休克的病人(ISS≥25)78例,随机分为限制组(40人)和常规组(38人).两组患者均因严重低氧血症和失血性休克行机械通气和体液复苏.分别监测凝血功能(PT和APTT)、碱剩余(BE)、血浆乳酸含量、氧分压、氧合指数及胸片变化情况,统计两组肺挫伤伴失血性休克病人的呼吸机通气时间、住ICU时间、急性呼吸窘迫综合症(ARDS)和多器官功能障碍综合征(MODS)发生率、治愈率和死亡率.结果 限制性补液 与常规补液均能

  19. 两种有创机械通气模式在肺挫伤患者的比较研究%Comparison of the Effect of Two Kinds of Invasive Mechanical Ventilations in the Treatment of Pulmonary Contusion

    Institute of Scientific and Technical Information of China (English)

    周文来; 郑祥德; 李充沛; 刘小毅; 张丽; 刘成

    2016-01-01

    目的 比较两种有创机械通气治疗肺挫伤患者的效果. 方法 回顾分析2011年8月—2015年4月肺挫伤患者60例,所有患者均采取经口气管插管机械通气,分为治疗组(n=30),通气模式为适应性支持通气+呼气末正压;对照组(n=30),通气模式为同步间歇指令通气+压力支持通气+呼气末正压.观察两组机械通气情况和血气分析指标. 结果 治疗组的机械通气时间、住ICU时间和VAP发生率少于对照组(P<0.05). 治疗后两组的血气指标均优于治疗前(P<0.05),治疗组效果优于对照组[PaO2 (64.8±3.0) mmHg vs (62.2±2.3) mmHg;PaCO2 (39.8±2.9) mmHg vs (42.3±1.5) mmHg; SaO2 (94.7±2.2)% vs (92.9±1.7)%; PaO2/FiO2 (162.2±6.5) vs (154.7±5.8), 均P<0.05]. 结论 肺挫伤患者采用ASV模式机械通气疗法可提高通气效果,改善血气指标,具有潜在的临床推广价值.%Objective To compare the effect of two kinds of invasive mechanical ventilations in the treatment of pulmonary contusion. Methods An analysis was conducted on 60 cases with pulmonary contusion enrolled from August 2011 to April 2015. All the subjects were treated by mechanical ventilation with orotracheal intubation. The patients were divided into the treatment group (n=30) and the control group (n=30) according with different treatments. The treatment group received ASV and PEEP, while the control group received SIMV, PSV and PEEP. Mechanical ventilation and blood gas analysis indexes were observed in both groups. Results Compared with the control group, the treatment group had shorter duration of me-chanical ventilation, less length of stay in the ICU and lower incidence rate of VAP, the differences were statistically signif-icant, P<0.05. After treatment, the values of blood gas indexes in both groups were better than those before treatment, P<0.05. Furthermore, the treatment group had better treatment effect than the control group after treatment in PaO2 [(64.8±3.0) mmHg vs (62.2±2.3)mm

  20. Effect of restrictive fluid infusion in the pulmonary contusion patients with haemorrhagic shock%限制性补液在肺挫伤伴失血性休克中的应用效果

    Institute of Scientific and Technical Information of China (English)

    古孜丽努尔.吐尼亚孜; 余泽鸿; 阿伊提拉汗.艾力

    2012-01-01

    目的 探讨限制性补液在肺挫伤伴失血性休克中的应用效果.方法 2009年1月~2011年1月,某院急诊科收治的肺挫伤伴失血性休克患者62例,依据入院顺序随机分为2组,观察组33例,对照组29例.2组患者均予常规基础治疗,对照组采取充分补液方式,观察组采取限制性补液方式,评价2组临床疗效及预后.结果 观察组平均输液量、治疗后平均动脉压(MAP)、中心静脉压(CVP)均低于对照组;观察组治疗后凝血功能、动脉血气分析结果改善均优于对照组;观察组脱机时间明显短于对照组,ARDS及MODS发生率、死亡率等低于对照组.结论 限制性补液应用于肺挫伤伴失血性休克,可显著改善凝血功能、缓解低氧血症及酸中毒,缩短脱机时间,降低ARDS、MODS发生率及死亡率,值得临床深入研究.%OBJECTIVE To explore the effect of limited fluid resuscitation on pulmonary contusion complicated with hemor-rhagic shock. METHODS From Jan. 2009 to Jan. 2011, 62 cases of patients in the emergency with pulmonary contusion complicated with hemorrhagic shock were divided into two groups according to the hospitalized sequence. The observation group included 33 cases, and the control group included 29 cases. Both groups received routine treatment. The control group received abundant fluid resuscitation and the observation group received limited fluid resuscitation. The clinical effect and prognosis of the two groups were evaluated. RESULTS The mean Infusion, MAP and CVP in the observation group were significantly lower than that in the control group. The improvement condition of coagulation function and arterial blood gas analysis in the observation group were better than that in the control group. The time of getting off the breathing apparatus in the observation group were significantly shorter than that in the control group, and the rates of ARDS, MODS and mortality in the observation group were significantly lower than

  1. 纤支镜下支气管肺泡灌洗在多发伤并肺挫伤中的应用%Application of Bronchoalveolar Lavage by Fibrobronchoscopy in Multiple Injury with Pulmonary Contusion

    Institute of Scientific and Technical Information of China (English)

    边革元; 郝江; 罗积慎; 张萍; 杨明浩; 刘军

    2011-01-01

    [Objective]To explore the efficacy of bronchoalveolar lavage by fibrobronchoscopy for the examination and treatment of multiple injury patients with pulmonary contusion. [Methods] Multiple injury patients with pulmonary contusion who needed invasive ventilation were randomly divided into control group and fibrobronchoscopy treatment group. Beside antibiotics, circulatory and respiratory support and corticoids,bronchoalveolar lavage was used in the treatment group. Bronchoalveolar lavage fluid included normal saline 100ml and ambroxol hydrochloride injection 150mg. Bronchoalveolar lavage at bedside was performed for 3times with once a day. Meanwhile sputum smear was performed. The efficacy was compared between two groups. [Results] Compared with the control group, the oxygenation index(PaO2/FiO2) target reaching (≥300mmHg) time, chest-X ray shadow fade time and invasive mechanical ventilation time in the fibrobronchoscopy treatment group decreased, and there were significant differences between two groups( P >0.05). Fibrobronchoscopy could promptly find mucosal injury and airway obstruction, and timely take local irrigate and medication for removing the obstruction. [Conclusion] Mechanical ventilation combined with bronchoalveolar lavage is a safe and effective measure for the treatment of multiple injury complicated with pulmonary contusion.%[目的]探讨纤支镜下支气管肺泡灌洗(BAL)对多发伤并肺挫伤患者的检查与治疗效果.[方法]将多发伤并肺挫伤且需使用有创机械通气患者分为对照与纤支镜治疗组,除抗感染、循环呼吸支持、皮质激素等治疗外,治疗组病程中均采用纤支镜,以生理盐水100 mL+盐酸氨溴索注射液150 mg作为灌洗液,床旁行BAL灌洗3次,每2天1次,并行痰检,比较两组的治疗效果.[结果]经纤支镜治疗组氧合指数(PaO2/FiO2)改善(≥300 mmHg)时间、胸片阴影消退时间、有创机械通气时间三项指标均较对照组有所

  2. 预见性护理在重度颅脑损伤合并肺挫伤患儿中的应用%Application of predictive nursing in children with severe craniocerebral craniocerebral injury combined with pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    郑福萍; 琚爱红

    2014-01-01

    ObjectiveTo explore application effect of predictive nursing in children severe craniocerebral injury combined with pulmonary contusion.Methods 60 children severe craniocere-bral injury combined with pulmonary contusion were divided into observation group and control group.The control group was received routine nursing while the observation group was given pre-dictive nursing.Nursing effect was compared between the two groups.Results The blood oxygen saturation in the observation group was higher than that in the control group,the infection time was longer than that in the control group,the infection rate and mortality rate was lower than that in control group,Karnofsky scores after intervention was higher than that in the control group,the hospitalization time was shorter than that in the control group,the results revealed that the differ-ence was statistical significant (P <0.05).The difference was statistical significant since nursing satisfaction in the observation group was higher than that in the control group (P <0.05).Con-clusion Preventive nursing could reduce infection in children severe craniocerebral injury combined with pulmonary contusion and improve the prognosis.%目的:探讨预见性护理在重度颅脑损伤合并肺挫伤患儿中的应用效果。方法将60例重度颅脑损伤合并肺挫伤的患儿分为观察组和对照组各30例,对照组采用常规护理,观察组在对照组的基础上采用预见性护理,比较2组的护理效果。结果观察组的血氧饱和度高于对照组,出现感染的时间长于对照组,感染率、病死率低于对照组,出院前 Karnofsky 预后评分高于对照组,住院时间短于对照组,差异有统计学意义(P <0.05);观察组家属的护理满意度高于对照组,差异有统计学意义(P <0.05)。结论预见性护理能够起到前瞻性护理的作用,可有效降低重度颅脑损伤合并肺挫伤患儿的感染率,改善预后。

  3. Therapeutic Effects of High Dose Dexamethasone Combined with Ulinastatin in Treating Sever Pulmonary Contusion%大剂量地塞米松联合乌司他丁治疗严重肺挫伤

    Institute of Scientific and Technical Information of China (English)

    陈喜云; 钮海弟; 徐善明; 钟金龙

    2011-01-01

    目的:研究大剂量地塞米松联合乌司他丁治疗严重肺挫伤的疗效与安全性.方法:选择58例严重肺挫伤患者,随机分为A组(n=29)和B组(n=29).A组接受常规治疗,包括使用地塞米松20~40 mg,2次/d,连续3 d.B组在常规治疗的基础上联合乌司他丁20万U加入0.9%氯化钠液100 mL静脉滴注,每8 h 1次,连用7 d;2组患者治疗第1、第7天行血气分析,并检测治疗第1、第4、第7天血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)的含量.比较治疗期间2组患者急性呼吸窘迫综合征(ARDS)的发生率.结果:治疗前2组血气分析指标及血清TNF-α、IL-6水平无显著差异(P>0.05);治疗后B组血气分析指标较同期A组显著改善(P<0.05),血清TNF-α、IL-6水平较A组显著下降更明显(P<0.05).ARDS发生率B组显著低于A组(P<0.05).结论:大剂量地塞米松联合应用乌司他丁能显著抑制炎症介质的释放,有效保护严重肺挫伤患者的肺功能.%Objective:To observe the therapeutic effects of high dose dexamethasone combined with Ulinastatin in treating sever pulmonary contusion. Methods.A total of 58 patients with sever pulmonary contusion were randomly divided into Group A(n = 29) and Group B(n = 29). Both Groups received routine treatment, including dexamethasone (20-40 mg intravenous drip twice one day and continued 3 days), while the patients of Group B(n = 29) were given Ulinastatin (200 kU intravenous drip once every 8 hours and continued 7 days) in addition. Blood gas analysis were detected on the 1st and 7th day and serum tumor necrnsis factor alpha(TNF-α) and interleukin 6(IL-6) levels were measured on 1st, 4th and 7th day in both groups. Results:The results of blood gas analysis and serum TNF-α, IL-6 levels were not different in both groups before therapy(P>0. 05). The results of blood gas anslysis in Group B were higher than those of Group A after treatment (P<0. 05). TNF-α and IL-6 in Group B decreased more significantly than

  4. An experimental study of pulsed ultrasound for treating skeletal muscle contusions%不同强度脉冲超声波促进大鼠骨骼肌挫伤修复的实验研究

    Institute of Scientific and Technical Information of China (English)

    杨志金; 舒彬; 曾登芬; 邓皓月; 方响琴

    2010-01-01

    Objective To evaluate the effects of pulsed ultrasound at different intensities on the healing of standardized contusions in an animal model. Methods Forty-eight 3-month-old, male Sprague-Dawley rats were given experimental contusions of the right gastrocnemius muscle before being divided into four groups randomly ( n =12 in each group): (1) a muscle injury control group (muscle injury without treatment); (2) a muscle injury and pulsed ultrasound (0.25 W/cm2 ) group; (3) a muscle injury and pulsed ultrasound ( 0.5W/cm2 ) group; and (4)a muscle injury and pulsed ultrasound ( 0.75 W/cm2 ) group. Pulsed ultrasound treatment ( frequency 3 mega Hz)was started 24 hours post injury and delivered 5 min daily for 14 days on the injured right hindlimb. At days 4, 7 and 14 after injury, muscle samples were analyzed through hematoxylin-eosin staining and immunohistochemistry for the detection of muscle satellite cells and desmin. Results The average optical density (IOD) of desmin-positive mononucleated cells had increased significantly at days 4, 7 and 14 post injury in the treatment groups compared to the control group, but with no statistically significant difference among the 3 ultrasound treatment groups. Conclusions The pulsed ultrasound treatment played a beneficial role in skeletal muscle regeneration after contusion. There was no significant dose-dependent effect over the intensity range of 0.25-0.75 W/cm2.%目的 观察不同强度脉冲超声波对大鼠骨骼肌挫伤修复的疗效.方法 共选取成年雄性SD大鼠48只,将其制成右侧腓肠肌挫伤模型,然后分为自然恢复组及超声波组.自然恢复组大鼠制模后未给予特殊处理,让其自然恢复;超声波组根据超声波强度不同,细分为A,B,C共3个亚组,于制模后24h分别接受强度为0.25,0.50,0.75 W/cm2的脉冲超声波(频率均为3mHz)治疗,每天治疗持续5min,共治疗14d.于制模后4,7及14d时取材,采用HE染色、免疫组化染色等手段检测各组大

  5. Investigation of surfactant protein-D and interleukin-6 levels in patients with blunt chest trauma with multiple rib fractures and pulmonary contusions: a cross-sectional study in Black Sea Region of Turkey

    Science.gov (United States)

    Kurt, Aysel; Turut, Hasan; Acipayam, Ahmet; Kirbas, Aynur; Yuce, Suleyman; Cumhur Cure, Medine; Cure, Erkan

    2016-01-01

    Objective Multiple rib fractures (RFs) and pulmonary contusions (PCs), with resulting systemic lung inflammation, are the most common injuries caused by blunt chest trauma (BCT) in motor vehicle accidents. This study examined levels of the inflammation marker interleukin (IL)-6 and those of the acute-phase reactant surfactant protein (SP)-D in patients with BCT. Design Prospective, cross-sectional, observational study. Setting Single-centre, tertiary care hospital in the Black Sea Region of Turkey. Participants The study included 60 patients with BCT who were hospitalised in our thoracic surgery department. Parameters measures The SP-D and IL-6 serum levels of patients with RFs (two or more RFs) (n=30) and patients with PCs (n=30) were measured after 6 hours, 24 hours and 7 days, and compared with those of age-matched and gender-matched healthy participants. Results The 6-hour serum SP-D levels of the RFs (p=0.017) and PCs (plung injury. The levels of the systemic inflammation marker IL-6 and those of the acute-phase reactant SP-D were elevated in the present study. The SP-D level may be used as a marker in the follow-up of BCT-related complications. PMID:27733410

  6. Clinical analysis of mechanical ventilation of tracheotomy treatment of multiple trauma combined pulmonary contusion%气管切开机械通气治疗多发伤合并肺挫伤临床分析

    Institute of Scientific and Technical Information of China (English)

    刘杉; 陈勇; 胡宝森

    2015-01-01

    Objective To analyze the clinical effect of mechanical ventilation of tracheotomy treatment of multiple trauma with pulmonary contusion.Methods 68 patients with multiple trauma combined pulmonary contusion in 500 patients with multiple trauma,who were selected as the research objects in our hospital from December 1995 to December 2010,were divided into tracheotomy group and non-tracheotomied group,with 34 cases in each group.To monitor the dynamic change of the patients regained consciousness,the subjective symptom,the vital signs of heart rate,rhythm,hematoid saturation,and blood pressure,the blood gas analysis,the oxygen index,and the X-ray appeara. To record all the research objects of the damage location,the injury severity score(ISS) which was the square sum of Indian physic AIS score as the evaluation standard of Abbreviated Injury Scale(AIS-90),the average using time of ventilator,the ICU monitoring time,the mortality within 1 month postoperative. Results The difference of damage location before operation in tracheotomy group compared with which in non-tracheotomied group was no statistical significance(P>0.05).The average using time of ventilator,the ICU monitoring time in tracheotomy group were shorter than which in non-tracheotomied group,the mortality within 1 month in tracheotomy group was less than which in non-tracheotomied group,the differences were statistical significance(P<0.05).ConclusionMultiple trauma combined pulmonary contusion has the complexity of treatment,has less attention to pulmonary contusion to delay the disease,should be treated with tracheotomy early,has significant effect to prevent ARDS,could improve ventilation,prevent atelectasis,eliminate secretion of small airway,prevent pulmonary infection.%目的:分析气管切开机械通气治疗多发伤合并肺挫伤临床疗效。方法1995年12月~2010年12月我院共收治多发伤500余例,选取68例合并肺挫伤病例作为研究对象,分为气管切开组(34

  7. Dynamic changes of sTREM-1 and TNF-α in different degrees of pulmonary contusion and its clinical signifi-cance%不同程度肺挫伤中 sTREM-1及 TNF-ɑ表达的动态变化及临床意义

    Institute of Scientific and Technical Information of China (English)

    陆志斌; 周存荣; 占根生; 吴卫兵; 徐晓晗; 吴延虎

    2015-01-01

    目的:探讨不同程度肺挫伤中可溶性髓样细胞触发受体-1(sTREM-1)及肿瘤坏死因子-ɑ(TNF-ɑ)的动态表达变化及其临床意义。方法设立健康体检人群组(A 组)为对照组。用定酶联免疫吸附试验(ELISA)法测定不同程度肺挫伤组中血清 sTREM-1和 TNF-ɑ含量在患者入院时及入院后1天、3天、7天的变化。结果肺挫伤时血清 sTREM-1较 A 组明显升高(P <0.05);TNF-ɑ含量(除 B 组第七天)较 A 组明显升高(P <0.05);sTREM-1及 TNF-α在肺挫伤早期均明显升高,肺挫伤伤情越严重则升高越明显,同时随着病情的好转而逐渐表达下降。结论 sTREM-1及 TNF-α可推荐作为临床评估肺挫伤严重程度及预后的有效指标。%Objective To study the dynamic changes of soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) and tumor necrosis factor-α (TNF-α) in different degrees of pulmonary contusion and its clinical significance. Methods The healthy people were selected as the control group. The levels of sTREM-1 and TNF-α in different degrees of pulmonary contusion and its changes on admission and 1, 3 and 7 days after admission were de-tected by enzyme linked immunosorbent assay (ELISA) method. Results The serum sTREM-1 in pulmonary contu-sion increased obviously compared with the control group (P < 0. 05). The serum TNF-α content of lung contusion (except the seventh day in the group B) was significantly higher in the study group than in the control group (P <0. 05). The sTREM-1 and TNF-α increased significantly in early pulmonary contusion, and with the severity of pul-monary contusion. With the improvement of the disease, the levels of sTREM-1 and TNF-α decreased gradually. Conclusion TNF-α and sTREM-1 can be recommended as the effective index in evaluating the severity and progno-sis of pulmonary contusion.

  8. 肺泡表面活性物质对肺挫伤后肺泡巨噬细胞功能的影响%Effects of pulmonary surfactant on alveolar macrophage function after pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    刘军强; 卢建; 潘铁文; 徐志飞

    2012-01-01

    Objective To observe the effects of porcine pulmonary surfactant(PPS) on the function of pulmonary alveolar macrophagesC AMs) in vitro, so as to explore the mechanism by which PPS treating pulmonary contusion in rats. Methods AMs were separated by adherent culture from bronchoalveolar lavage fluid of rats with pulmonary contusion. The AMs were then cultured with media containing PPS (100 jig/ml or 200 fig/ml) , LPS (20 jug/ml) +PPS (100 jug/ml or 200 Fg/ ml), or LPS (20 /jg/ml) alone for 2 h. Then the phagocytic function of AMs in each group was examined with fungus. TNF-a mRNA was determined by RT-PCR in AMs of each group. AMs untreated with PPS and LPS were taken as blank control. Results The phagocytic function of the AMs and the expression of TNF-a mRNA were not significantly affected by PPS alone compared with the control group. LPS stimulation increased the phagocytic function of AMs and the TNF-a mRNA expression in AMs. PPS showed no significant effect on LPS-induced increase of phagocytic function of AMs, but it could greatly inhibit LPS-induced TNF-a mRNA increase. Conclusion PPS has no noticeable effect on the phagocytic function of the AMs, but it can inhibit TNF-a mRNA expression induced by LPS in AMs.%目的 观察研究外源性猪肺表面活性物质(PPS)对肺挫伤大鼠肺泡巨噬细胞(AM)的吞噬功能和分泌功能的影响,探讨补充PPS对肺挫伤大鼠的治疗作用及其机制.方法 采用贴壁培养的方法,分离肺挫伤大鼠肺泡灌洗液中的AM,将分离的AM于普通培养液、含PPS(100μg/ml或200 μg/ml)的培养液、含LPS(20 μg/ml)的培养液或含LPS(20 μg/ml)+PPS(100 μg/ml或200 μg/ml)的培养液中培养2h后,采用真菌吞噬法测定各组细胞的吞噬功能;采用RTPCR方法测定各组细胞中TNF-α mRNA含量.结果 与对照相比,PPS单独作用对AM的吞噬功能和TNF-α mRNA含量无明显影响.经LPS刺激后AM的吞噬功能增强,TNF-α mRNA含量明显增高.PPS对LPS导致的吞噬

  9. Application Experience of the Department of Thoracic Surgery Operation in Patients with Pulmonary Contusion and Laceration%普胸外科手术在肺挫裂伤修补患者中的应用体会

    Institute of Scientific and Technical Information of China (English)

    孙升

    2015-01-01

    目的探讨普胸外科手术在肺挫裂伤修补患者中的临床治疗效果。方法选取2012年4月~2014年4月我院收治的80例肺挫裂伤修补患者资料进行分析,根据不同治疗方案将患者分为对照组和实验组,对照组采用乌司他丁治疗,实验组采用普胸外科手术治疗,比较两组疗效。结果实验组EICU监护时间为(6.8±2.1)d,显著短于对照组(<0.05);实验组3例发生ARDS,发生率为7.5%,死亡率为0%,显著低于对照组(7例发生ARDS,发生率为17.5%;4例死亡,死亡率为10%)(<0.05)。结论肺挫裂患者采用普通外科手术修复效果理想,能够降低手术创伤,提高临床疗效,值得推广使用。%Objective To discuss general thoracic surgeries' Clinical curative ef ect on patients with pulmonary contusion repair.Methods Select materials of 80 patients with pulmonary contusion repair our hospital patients accept Between April 2013 and April 2014, to analyze it . According to the dif erent treatment,we divided the patients into control group and experimental group.The control group treated patients with ulinastatin,and The experimental group used the general thoracic surgery to patients.To compare two groups of curative ef ect.Results The experimental group EICU monitoring time was (6.8±2.1) days,and it is significantly shorter than the control group ( <0.05).The experimental group had 3 cases of ARDS.The incidence was 7.5%, the death rate was 0%.It is Significantly lower than the control group (7 cases of ARDS,The incidence was 17.5%;4 cases of death,The mortality rate of 10%) ( < 0.05).Conclusion Patients with sharp crack to use common surgical repair,its ef ect is ideal.It can reduce surgical trauma and improve clinical curative ef ect, and it is worthy of promotion ot use.

  10. 大鼠钝性脊髓损伤后BMPR Ia型受体的表达%Expression of bone morphogenetic protein receptor lA in rats after contusive spinal cord injury

    Institute of Scientific and Technical Information of China (English)

    李华凤; 江兴华; 邹定全; 曹启林; 吕静; 李媛; 张慧芳; 王亚平

    2011-01-01

    目的 观察脊髓损伤后BMPR Ia型受体的表达.方法 运用免疫组织化学方法,首先检测3种BMP受体(BMPR)Ia、Ib、II型在正常成体大鼠脊髓中的表达分布.运用大鼠钝性脊髓损伤模型,以150 kdyn的撞击力直接撞击脊髓,观察动物撞击后1、3、7、14、30、60 d后脊髓中BMPR Ia的表达改变.结果 在正常成年大鼠脊髓中,BMPR Ia、II型受体主要在少突胶质细胞、灰质神经元中表达,在部分星形胶质细胞和大多数小胶质细胞中表达.灰质神经元中未检测到Ib型受体的表达或表达很低.脊髓损伤后,BMPR Ia在星形胶质细胞中表达激剧增加,高表达可持续至损伤后1个月;脊髓损伤诱导脊髓小胶质细胞活化,活化的小胶质细胞中表达BMPR Ia明显增加.结论 大鼠脊髓损伤后,诱导BMPR Ia受体在星形胶质细胞、小胶质细胞激剧增加,BMPR Ia高表达提示BMP信号在胶质细胞的重要病理生理作用,这一发现为进一步研究BMP信号的功能作用提供基础.%Objective To observe the expression pattern of bone morphogenetic protein receptor IA (BMPR I A) in rats after contusive spinal cord injury. Methods The expressions of BMPR IA, IB, and II were detected by immunochemistry in the spinal cord of normal adult rats, and the expression of BMPR IA was detected in the infinite horizons impactor model at 1, 3, 7, 14, 30, and 60 days after spinal cord injury. Results In the spinal cord of normal adult rats, BMPR IA and II were expressed predominantly in the oligodentrocytes and neurons in the grey matter, and also in some astrocytes and numerous microglia cells. Only a low level of BMPR IB expression was detected in the neurons of the grey matter. After spinal cord injury, the expression of BMP IA markedly increased with sustained strong expression in the astrocytes till one month after the injury; its expression was also increased obviously in the microglia cells activated by the injury. Conclusion The

  11. 肺挫伤患者多层螺旋CT影像学表现与预后%Association of multi-slice spiral CT images of occult pulmonary contusion with disease prognosis

    Institute of Scientific and Technical Information of China (English)

    王凌; 唐怨; 孔德会; 陈友强; 付子文; 杨华

    2014-01-01

    探讨肺挫伤(occult pulmonary contusion,OPC)患者多层螺旋CT(multi-slice spiral CT,MSCT)影像学表现与预后.对143例胸部钝性伤后行常规胸部正位平片和MSCT检查患者影像及临床资料进行回顾性分析.共87例患者检出肺挫伤,其中显性挫伤58例,24例继发肺炎,13例继发脓胸,16例继续发展为急性呼吸窘迫综合征(ARDS);隐匿性肺挫伤(OPC)29例,6例继发肺炎,1例发展为ARDS,未见继发脓胸患者;其余56例中7例继发肺炎,1例继发ARDS,未见继发脓胸患者.在OPC患者中,所有挫伤局限于一个肺叶的患者临床预后均较好;所有继发肺炎的患者挫伤范围均大于两个肺叶.OPC患者总体临床预后较好,MSCT能可靠的评价挫伤的范围,对OPC患者的临床治疗具有一定的指导意义.

  12. Guiding role of USCOM in fluid management of ARDS patients induced by pulmonary contusion%USCOM对肺挫伤致ARDS患者液体管理的指导作用

    Institute of Scientific and Technical Information of China (English)

    张伟强; 李玉著; 王晓芝; 姜海明; 王惠娟

    2014-01-01

    Objective To study the guiding role of ultrasonic cardiac output monitor (USCOM ) in fluid management of ARDS patients induced by pulmonary contusion .Methods A total of 30 ARDS patients induced by pulmonary contusion were random-ly divided into the experimental group and the control group (n=15 each) ,and the experimental group was given the fluid man-agement according to USCOM ,and the control group according to CVP .Liquid intake and output volumes after 24 ,48 and 72 h were calculated .Arterial blood lactic acid and oxygenation index were measured at 1th ,2th ,3th ,5th and 7th day .Patients were followed until time of hospital discharge to determine hours of mechanical ventilation ,hours of vasoactive agent support and 28 d mortality .Results There were no statistical difference in the liquid balance volume of intake and output between the two groups after 24 ,48 and 72 h .statistical difference was found in oxygenation index between the two groups at 5th day .Oxygena-tion index improved earlier in the USCOM group .Hours of mechanical ventilation of the USCOM group was significantly shor-ter than the patients'of the CVP group ,however ,there was no statistical difference between the two groups in hours of vasoac-tive agent support .Conclusions The fluid management using USCOM can earlier improve the oxygenation index and shorten duration of mechanical ventilation ,but can't significantly decrease the 28 d mortality rate of ARDS patients induced by pulmona-ry contusion .%目的:研究超声心输出量监测仪(USCOM )对肺挫伤致急性呼吸窘迫综合征(ARDS)患者的液体管理在临床工作中的指导作用。方法选取30例肺挫伤致 ARDS的患者作为研究对象,随机分为实验组和对照组各15例,实验组通过 US-COM监测指导患者的液体管理,对照组通过监测中心静脉压(CVP)指导液体管理,比较两组患者入住ICU后24、48、72 h的液体出入量,第1、2、3、5、7天的动脉血乳

  13. The study of protective ventilation strategy on severe pulmonary contusion%保护性机械通气治疗严重肺挫伤的疗效评价

    Institute of Scientific and Technical Information of China (English)

    严四军; 刘燕; 曹祥; 乔德成; 邓波荣

    2010-01-01

    目的 研究保护性机械通气治疗严重肺挫伤的临床效果.方法 将53例严重肺挫伤患者按住院日期单双数随机分为两组:保护性通气组25例,潮气量6-8 ml/kg,传统通气组28例,潮气量12-15 ml/kg,其他呼吸机参数按同一策略调整.观察机械通气治疗前后血气参数的变化,比较两组呼吸机使用时间、病死率及并发症的发生率.结果 两组患者机械通气后动脉血氧分压、氧合指数均明显改善,两组比较差异无统计学意义.保护性通气组呼吸机使用时间(149.8±77.3)h,死亡7例(28.0%),传统通气组呼吸机使用时间(203.3±85.2)h,死亡11例(39.3%),两组呼吸机使用时间和病死率比较差异有统计学意义(P<0.01).且保护性通气组并发肺部感染、气胸,纵隔气肿的发生率均低于传统通气组(P<0.05),急性呼吸窘迫综合征的发生率虽低于传统通气组,但差异无统计学意义(P>0.05).结论 保护性机械通气可有效改善严重肺挫伤患者的肺氧合功能,提高动脉血氧分压,显著缩短呼吸机使用时间,降低病死率和呼吸机相关并发症的发生率,改善预后,值得临床推广.%Objective To investigate the effect of protective ventilation strategy on severe plumonary contusion. Methods Fifty-three patients suffered from severe pulmonary contusion were randomly divided into the protective ventilation group (25 cases,the tidal volume was 6-8 ml/kg) and the traditional ventilation group (28 cases,the tidal volume was 12-15 ml/kg). The blood gases were examined before and after ventilation. Moreover,the time for ventilation therapy,mortality rate and morbidity of complications were compared between the two groups. Results After ventilation,arterial oxygen content and oxygenation index were improved obviously in two groups,and there was no significant difference between the two groups. Average time for ventilation therapy and mortality rate in the protective ventilation group were

  14. 组织多普勒同步显像技术在猪闭合性心肌挫伤早期诊断中的应用探讨%The value of echocardiography for early diagnosis of dose cardiac muscle contusion in piss

    Institute of Scientific and Technical Information of China (English)

    袁彬彬; 胡成平; 王莎莎; 张卫达; 王晓武

    2008-01-01

    目的 探讨组织多普勒同步显像(TSI)技术在闭合性心肌挫伤早期诊断中的价值.方法 选取贵州小型巴马猪10头,采用自制小型撞击器成功建立10只猪闭合性心肌损伤的动物模型.分别在伤前及伤后0.5、2、4、8、12 h行超声心动图检查,并与病理TTC心肌染色结果 对照分析.结果 在撞伤后0.5 h即可观察到损伤节段的相应变化,显示挫伤节段主要为前壁和侧壁等.心肌挫伤后应用三种超声技术所观察的异常节段、室壁运动评分、室壁收缩期峰值速度时间评分室壁节段运动指教(WMSI)、收缩期峰值速度时间指数(TPI)均较伤前明显增加(P<0.01).结论 2DE能够较准确地反映心肌挫伤的部位.TSI可直观、准确地分辨心肌挫伤后损伤区的边界、判断异常节段,不易混淆,其在猪心肌挫伤早期诊断中有着2DE不可比拟的优势.%Objective To study the value of two-dimensional Echocardiography(2DE)and doppler tissue synchronization imaging (TSI) during early diagnosis of close myocardial contusion.Methods 9 small Guizhou-Panama pigs were used.The close myocardial contusion animal model was successfully established by using the serf made small impactor.Echocardiography wag applied before and after injury for 0.5,2,4,8 and 12h respectively,these data were analyzed together with the TYC pathological results.Results After the strike for 0.5h,the location and area of the damage call be directly and rapidly shown by 2DE and TSI,which showed that after myocardial contusion (MC),main damaged areas are anterior and lateral myocardial walls.After myocardial contusion MC,three echocardiography techniques were used to observe the scale of the abnormal segment,the movement of the myocardial wall,Time tO Peak of Systolic Velocity and wall motion segmental inter(WMSI),Time to Peak of Systolic Velocity index(TPI),which all were increased than that pre-injury.Conclusion 2DE and TSI can be used for accurately early

  15. Breathing machine experience in the treatment of 21 patients with bilateral flail chest complicated with severe pulmonary contusion using%双侧连枷胸合并严重肺挫伤21例的呼吸机治疗体会

    Institute of Scientific and Technical Information of China (English)

    陈希涛; 孙筱笛; 韩立波; 丛巍; 杜江; 张林

    2013-01-01

    Objective To study the effect of mechanical ventilation in the treatment of traumatic flail chest complicated with pulmonary contusion and respiratory failure. Methods 21 patients with bilateral flail chest combined with severe pulmonary contusion and respiratory failure were treated with invasive mechanical ventilation, and then the blood gas and value of pH, PaO2 , PaCO2 , and HCO3 were compared before and after the treatment. Results The values of PH, PaO2 , PaCO2 , and HCO3 were all better improved after the treatment. Conclusion The mechanical ventilation is an effective method in the treatment of patients with flail chest complicated with severe pulmonary contusion and respiratory failure.%目的 探讨机械通气治疗创伤性连枷胸合并肺挫伤、呼吸衰竭的疗效.方法 对21例双侧创伤性连枷胸合并严重肺挫伤、呼吸衰竭未行手术内固定之患者行机械通气治疗后分析血气分析等各种参数的变化.结果 机械通气治疗后动脉血PH值、氧分压(PaO2) 、二氧化碳分压(PaCO2) 、碳酸根离子(HCO-3)、氧合指数(PaO2/FiO2)等均较前明显改善.结论 对于双侧创伤性连枷胸合并严重肺挫伤、呼吸衰竭的患者,机械通气内固定治疗行之有效.

  16. 双额叶脑挫裂伤所致脑中心疝68例抢救报告%Report on the rescue of brai n centre hernia caused by double frontal lobe contusion and laceration in 68 csaes

    Institute of Scientific and Technical Information of China (English)

    王平振; 刘秉柱; 杨光; 于涛; 张洋; 邢伟

    2013-01-01

    Objective:To research into the rescue and treatment of brain centre hernia caused by double frontal lobe contusion and lac -eration .Methods:Using analysis of clinical data by looking back on the patients with brain centre hernia caused by double frontal lobe contusion and laceration .Results:55 lives were saved and 13 died after treating the 68 patients with double frontal lobe contusion and laceration.Best treatment appeared in the interval period .Conclusion: Once brain centre hernia appears because of double frontal lobe contusion and laceration of the brain ,the rate of death and disability is high.Close observation should be done ,checking vital signs of life ,especially taking notice of the pupil becoming small and watching out for the occurrence of tardive brain centre hernia and Diencephalons period should be the key period for salvage .%目的:探讨双额叶脑挫裂伤所致脑中心疝的抢救与治疗。方法:对68例双额叶脑挫裂伤所致脑中心疝的患者的临床资料进行回顾性分析。结果:对68例双额叶脑挫裂伤并发脑中心疝的患者经治疗后挽救生命55例,死亡13例,间脑期手术效果最好。结论:双额叶脑挫裂伤一旦出现脑中心疝,死亡率或病残率高,应在伤后严密观察病情,监测生命体征,尤其注意瞳孔变小的情况出现,警惕迟发型脑中心疝的发生,间脑期及时手术是提高疗效的关键。

  17. The expression of von Willebrand factor and interleukin-8 in severe pulmonary contusion patients%严重肺挫伤患者冯·维勒布兰德因子,白介素8的动态变化及其意义

    Institute of Scientific and Technical Information of China (English)

    钱进先; 陆骏灏; 陆士奇; 赵益明

    2011-01-01

    Objective To study the clinical changes of von Willebrand factor( vWF) and interleukin-8 (IL-8) in patients with severe pulmonary contusion. Methods Sixty-three patients with severe pulmonary contusion were divided into three different classifications for the sake of comparison in different respects, namely (1) severe pulmonary contusion with ARDS group and severe pulmonary contusion without ARDS group, (2) survival group and non-survival group, and (3) ISS score <20 group and ISS scored 20 group. In addition, the normal control group was set up. The levels of plasma vWF and serum IL-8 were respectively detected by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) within 24 hours of injury and 1,3,5 and 7days after injury. The regularity of their changes was observed and the correlation factors were analyzed from the data. Results Compared with normal controls, the concentrations of plasma vWF and serum IL-8 were significantly increased in patients with severe pulmonary contusion in all intervals of detection. The concentrations of plasma vWF escalated gradually in severe pulmonary contusion with ARDS, and reached significantly higher levels in 5 days and 7 days after injury compared with those without ARDS group (P <0. 05). The increase in concentrations of serum IL-8 peaked in 5day after injury, and then declined. The levels of serum IL-8 were higher in patients with severe pulmonary contusion with ARDS group than those in this kind of patients without ARDS group. The levels of plasma vWF and serum IL-8 were higher in non - survival group than those in survival group (P < 0.05). The increase in levels of plasma vWF and serum IL-8 peaked and then declined in 5 days in ISS score 3:20 group, whereas it peaked and declined in 3 days after injury in ISS score < 20 group. The level of plasma vWF was positively correlated with platelets and negatively correlated with oxygenation index. The levels of serum IL-8 was positively correlated with white blood

  18. Clinical Study on Risk Factors of Stress Ulcer in Patients With Acute Cerebral Contusion and Laceration%急性脑挫裂伤患者发生应激性溃疡危险因素的临床研究

    Institute of Scientific and Technical Information of China (English)

    顾建军

    2015-01-01

    目的:探讨急性脑挫裂伤患者发生应激性溃疡的危险因素。方法选择我院脑外科2014年1月~2015年12月收治的急性脑挫裂伤患者60例,将60例病例分别按照性别、年龄、损伤程度、血糖、血压、体温、手术治疗、鼻饲情况分为两组,分别统计每组患者出现应激性溃疡的例数,进行组间数据比较。结果本组60例急性脑挫裂伤患者中共并发应激性溃疡16例,发生率为26.7%;其中发生应激性溃疡与患者的性别和年龄无关,P>0.05,与患者的脑损伤程度、体温、血糖、血压、鼻饲、手术治疗相关,P<0.05。结论高血糖、低血压、损伤程度较重、发热、接受手术治疗、采用鼻饲均是引发急性脑挫裂伤患者应激性溃疡的危险因素,临床上针对这些危险因素应采用适当的预防措施,可以有效的降低发生率,对促进急性脑挫裂伤患者尽早康复和提高其预后质量具有重要意义。%Objective To investigate the acute cerebral contusion in stress ulcer in patients with risk factors.Methods 60 patients with acute cerebral contusion were chosen in January 2014 ~ December 2015, 60 cases respectively according to gender, age, degree of injury, blood glucose, blood pressure, body temperature, surgical treatment, nasogastric divided into two groups, respectively statistics in stress ulcer patients in each group, or to compare data between groups.Results 60 patients with acute cerebral contusion of the communist party of 16 cases complicated with stress ulcer, the rate of 26.7%, which occur stress ulcer has nothing to do with the patient's age and gender,P > 0.05, and the degree of the patients with brain injury, body temperature, blood sugar, blood pressure, nasogastric, surgical treatment, P < 0.05.Conclusion Hyperglycemia, low blood pressure, damage degree is heavier, fever, surgery, using nasal feeding are caused by acute cerebral contusion in stress ulcer in

  19. Clinical observation of early rib internal fixation for treatment of traumatic flail chest combined with pulmonary contusion%早期肋骨内固定术治疗创伤性连枷胸合并肺挫伤的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    胡德东; 许世强

    2013-01-01

    Objective To observe the clinical effect of early rib internal fixation for the treatment of traumatic flail chest combined with pulmonary contusion.Methods The medical records of patients with flail chest combined with pulmonary contusion were analyzed retrospectively,including 46 cases underwent thoracotomy and ribs internal fixation and 40 cases non operation treatment.The effect and complications were compared between the two groups.Results In the treatment group,the time of therapy in ICU,ventilator support time,atelectasis,thoracic deformity,mortality were significantly lower than that in the control group (P<0.05).The pulmonary function test was better than that of non operation group.Conclusion Early thoracotomy and rib fixation for treatment of traumatic flail chest and pulmonary contusion can early assess thoracic viscera injury,timely eliminate chest wall malacia and paradoxical respiratory movement,improve respiratory function and decrease the complications.%目的 观察创伤性连枷胸合并肺挫伤行早期开胸探查、肋骨内固定术的临床效果.方法 将2009年1月~2012年12月采用早期开胸探查、肋骨内固定术治疗的46例创伤性连枷胸合并肺挫伤患者设为治疗组,同期保守治疗的40例患者设为对照组,比较两组患者的疗效及并发症情况.结果 治疗组ICU入住时间、呼吸机支持时间、肺不张、胸廓畸形、死亡率等均明显低于对照组(P<0.05),出院行肺功能检查各参数明显优于对照组(P<0.05).结论 早期行开胸探查、肋骨内固定术治疗创伤性连枷胸合并肺挫伤可以早期评估胸内脏器损伤情况并行相应处理,能及时消除胸壁软化及反常呼吸运动,改善呼吸功能,减少并发症,改善预后.

  20. Combined Treatment of Mechanical Ventilation and External Fixation of Chest Wall for Frail Chest Complicated by Pulmonary Contusion%机械通气加胸壁外固定在连枷胸合并肺挫伤治疗中的作用

    Institute of Scientific and Technical Information of China (English)

    王亚莉; 付茂勇

    2009-01-01

    Objective To evaluate the therapeutic effect of combined treatment of mechanical ventilation and external fixation of chest wall for frail chest complicated by pulmonary contusion. Methods A retrospective analysis was conducted based on the clinical data of 21 patients with frail chest complicated by pulmonary contusion between January, 2005 and December, 2008. Results Parameters of the patients' blood gas analysis such as PaO2,SpO2,and PaO2/FiO2 all significantly improved and PaCO2 significantly decreased compared with those before the treatment( P<0.01);meanwhile, the patients' comfort level was significantly improved( P< 0.01).Of 22 patients, 19 were successfully cured and 3 died. Conclusion It was found that the combined treatment of mechanical ventilation and external fixation of chest wall was able to significantly improve the conditions of the patients with frail chest complicated by pulmonary contusion as well as lessen their discomfort.%目的 评价机械通气加胸壁外固定在治疗连枷胸合并急性肺挫伤中的作用.方法 回顾性总结分析我院2005年1月至2008年12月的22例行机械通气加胸壁外固定治疗连枷胸合并肺挫伤的患者临床资料.结果 行机械通气加胸壁外固定术联合治疗后动脉血氧分压(PaO2)、二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)和脉搏血氧饱和度(SpO2)均较治疗前有明显改善(P<0.01),患者舒适度明显提高(P<0.01);治愈19例,死亡3例.结论 机械通气加胸壁外固定在治疗连枷胸合并急性肺挫伤中能明显改善病情,减轻患者不适.

  1. 复元活血汤加味对肺挫伤患者的疗效及对IL-6、IL-18和CRP的影响%Curative effect of Fuyuan Huoxue Tang on patients with pulmonary contusion and its impact on serum IL-6, ;IL-18, and CRP

    Institute of Scientific and Technical Information of China (English)

    张振坤; 李向莉; 周国云; 李秀荣; 朱会焕

    2014-01-01

    Objective To investigate the clinical efficacy of Fuyuan Huoxue Tang on patients with pulmona-ry contusion and its impact on serum IL-6, IL-18, and CRP. Methods 160 pulmonary contusion patients were ran-domly divided into the control group and the treatment group, 80 cases in each group. All patients were given the conventional therapy, and the treatment group was additionally treated with Fuyuan Huoxue Tang. The efficacy of the two groups was compared before and after the treatment, and the levels of serum IL-6, IL-18, and CRP were detec-ted. Results After the treatment, the levels of serum IL-6, IL-18, and CRP were significantly lower in the treat-ment group than in the control group ( P <0. 05 ) . The incidence of lung infection, mechanical ventilation, and ARDS was obviously lower in the treatment group than in the control group (P<0. 05). Conclusion Fuyuan Huox-ue Tang can reduce cytokine-mediated protective effect and inhibit inflammatory reaction in the treatment of patients with pulmonary contusion.%目的:探究复元活血汤加味对肺挫伤患者的疗效及对血清中IL-6、IL-18和C反应蛋白( CRP)的影响。方法将我院收治的160例肺挫伤病人按数字法分为治疗组和对照组各80例,对照组施行常规治疗,治疗组80例在治疗组基础上运用加味复元活血汤,并对比疗效,治疗前后分别检测两组白细胞介素-6(IL-6)、白细胞介素-18(IL-18)、(CRP)。结果治疗组治疗后血清中IL-6、IL-18和CRP含量较对照组明显降低(P<0.05),治疗组肺部感染发生率、机械通气率、ARDS发生率均低于对照组(P<0.05)。结论加味复元活血汤可减轻细胞因子介导,抑制炎性反应,疗效确切,值得应用。

  2. 参麦注射液对急性肺挫伤患者TNF-α、IL-6和IL-8的影响%Effects of Shenmai injection on TNF-α、 IL-6 and IL-8 in patients with acute pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    杨剑虹; 陈晓娟; 唐忠志

    2011-01-01

    目的 观察参麦注射液对急性肺挫伤患者炎性细胞因子肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)的影响.方法 选择70例急性肺挫伤患者,随机分为对照组和治疗组,各35例.两组均给予常规西医治疗,治疗组在此基础上加用参麦注射液治疗,两组疗程均为7 d.观察急性肺挫伤患者平均住院时间、肺部感染率、急性呼吸窘迫综合征(ARDS)发生率,比较两组患者血清TNF-α、IL-6、IL-8变化情况.结果 治疗组患者平均住院时间、肺部感染率、ARDS发生率均较对照组明显降低(P均<0.05=;治疗7 d 后,治疗组患者血清TNF-α、IL-6、IL-8水平较对照组有明显降低(P<0.05或P<0.01=.结论 参麦注射液能显著减少急性肺挫伤患者炎性细胞因子TNF-α、IL-6、IL-8的产生,抑制炎症反应.%Objective To observe the effects of shenmai injection on tumor necrosis factor-a(TNF-α) 、Interleukin-6( IL-6 ) and Interleukin-8 (IL-8) levels in patients with acute pulmonary contusion. Methods 70 patients with acute pulmonary contusion were randomly divided into routine treatment group ( n = 35) and shenmai injection treatment group ( n = 35 ). Both groups were given routine treatment, while the patients of shenmai injection treatment group were given shenmai injection in addition, for 7 day. Average stay, incidence of pulmonary infection and respiratory distress syndrome (ARDS) in patients with acute pulmonary contusion were observed. The changes of serum TNF-α, IL-6 and IL-8 levels were compared in both groups. Results The average stay, incidence of pulmonary infection and ARDS ( P < 0.05 ) in shenmai injection treatment group were significantly decreased, the serum TNF-α、 IL-6 and IL-8 levels in shenmai injection treatment group were lower than those in routine treatment group (P < 0.01 or P < 0.05 ) after 7 day. Conclusion shenmai injection can significantly reduce the production of

  3. 肺挫伤患者早期超敏C反应蛋白、D-二聚体及肌钙蛋白I水平的临床意义%The clinical significance of hypersensitive C-reactive protein, D-dimer, and troponin I levels in patients with early-stage lung contusion

    Institute of Scientific and Technical Information of China (English)

    欧阳茴香; 刘彦宇; 李臻

    2015-01-01

    目的:观察超敏c反应蛋白(hs-crP)、d-二聚体(dd)及肌钙蛋白i(cTni)在肺挫伤后急性呼吸窘迫综合征(acute respiratory distress syndrome,ards)患者中的变化情况,探讨其临床意义。方法对128例急性肺挫伤患者入科24小时内测定hs-crP、dd、cTni水平,追踪观察1周内患者伤情变化,终点事件为ards。依据检测结果分为ards组和对照组。结果128例肺挫伤患者中1周内发生ards 29例。ards组hs-crP、dd和cTni值分别为(7.89±3.24)mg/l、(5.32±2.14)μg/ml和(2.34±1.04)ng/ml,均明显高于对照组的(6.08±2.46)mg/l、(4.26±2.08)μg/ml和(1.87±0.98)ng/ml(P<0.05)。结论hs-crP、dd及cTni水平可以作为肺挫伤后ards的病情评估指标。%Objective To observe the variation of hypersensitive c-reactive protein (hs-crP), d- dimer (dd) and troponin i (cTni) patients with acute respiratory distress syndromes(ards)after lung contusion and to explore its clinical significance.Method Hs-crP, dd, cTni levels of 128 patients with acute pulmonary contusion were measured within 24 hours after being enrolled into the department and their injury condition was followed up for a week with ards defined as the clinical endpoint. Based on the test results, they were divided into the ards and the normal group.Result 29 cases of ards occurred in 128 patients with pulmonary contusion within 1 week. Hs-crP value, dd value and cTni value in the ards group were (7.89 ±3.24)mg/l,(5.32±2.14)μg/ml,and(2.34±1.04)ng/ml,respectively,significantly higher than those of the control group which were(6.08±2.46)mg/l,(4.26±2.08)μg/ml,(1.87±0.98)ng/ml(P<0.05). Conclusion Hs-crP, dd and cTni levels can be used as indicators to assess the ards after lung contusion.

  4. The effects of Dahuang-tongfu therapy on inflammatory indexes and lung fluid metabolism in patients with severe pulmonary contusion%大黄通腑法对严重肺挫伤患者炎症指标及肺水代谢的影响

    Institute of Scientific and Technical Information of China (English)

    潘永; 张斌; 马明远; 徐杰; 区嘉玲; 卫女仲

    2013-01-01

    Objective To explore the effects of Dahuang-tongfu therapy on inflammatory factors and lung fluid metabolism in patients with severe pulmonary contusion. Methods A prospective,randomized,non-blinded clinical trial was conducted. Sixty patients with severe pulmonary contusion were randomly divided into two groups:conventional therapy control group and traditional Chinese medicine(TCM)therapy group(30 cases in each group). In this study,the conventional therapy control group received the routine treatment and placebo(starch capsules)and TCM therapy group received the routine treatment and additionally took 4 rhubarb capsules(each capsule contained crude drug 0.4 g)once orally or intra-gastric administration via a gastric tube,3 times a day,the therapeutic course in the two groups being 5 days. Before therapy and on the 5th day after therapy in both groups,the patients' venous blood samples in both groups were collected to test tumor necrosis factor-α(TNF-α)and interleukin-6 (IL-6),and the extra-vascular lung water index(EVLWI),white blood cell(WBC)count and blood lactic acid(Lac), etc. In the mean time,the pulmonary contusion scores were compared between the two groups before and after the therapy. Results There were 28 patients actually enrolled in each group. Before the treatment in both groups,no statistical significant differences were found in the levels of TNF-α(ng/L),IL-6(ng/L),WBC(×109/L),EVLWI (ml/kg),Lac(mmol/L)and pulmonary contusion scores(all P>0.05). And after the treatment,the above indexes were obviously decreased in both groups(all P0.05),治疗后上述各指标均较治疗前明显下降(均P<0.05),且以中药治疗组下降更显著(TNF-α:1.04±0.33比1.39±0.35,IL-6:81.05±22.35比96.99±28.77,WBC:9.30±1.23比10.66±1.56,EVLWI:6.44±1.23比8.05±2.13,Lac:0.93±0.45比1.68±0.67,肺挫伤评分:5.25±0.84比5.29±0.81,均P<0.05).结论大黄通腑法治疗可明显降低严重肺挫伤患者TNF-α、IL-6、EVLWI的水平,抑制

  5. Changes of interleukin-17 and effects of L-Arginine on rats lung with traumatic pulmonary contusion%大鼠肺挫伤白细胞介素17含量变化及L-精氨酸的影响

    Institute of Scientific and Technical Information of China (English)

    王方敏; 万黎; 赵建国; 王进

    2012-01-01

    Objective:To investigate the changes of interleukin-17 CIL-17) and the effects of L-arginine on traumatic pulmonary contusion. Method: Sixty Sprague-Dawley rats were randomly divided into three groups, i. e. normal group, model group, and L-arginine group. The model of traumatic pulmonary contusion was established with chest-impacter. Then the rats in the L-arginine group were injected intravenously with L-arginine in a dose of 250 mg/kg. All rats were sacrificed at 24 hours after the models were established. EL1SA was adopted to detect the levels of IL-17 in lung tissue homogenate as well as in bronchoalveolar lavage fluid (BALF). The activity of myeloperoxidase (MP()) in the lung tissue was measured. Result:The IL-17 levels in lung tissue homogenate as well as in BALF were higher in model group than those in the control group (all P<0. 01). Compared with the model group, IL-17 and the activity of MPO in lung tissue decreased significantly in the L-arginine group (P<0. 05). Conclusion: The expression of IL-17 increased in traumatic pulmonary contusion rats. L-arginine treatment can down-regulate the expression of IL-17, MPO, and ameliorate the microcirculation of rats lung with traumatic pulmonary contusion.%目的:了解白细胞介素17(IL-17)在大鼠创伤性肺挫伤中的含量及意义,并观察L-精氨酸的影响.方法:60只SD大鼠随机分为正常组、模型组和L-精氨酸组,每组20只.采用胸部撞击器制备肺挫伤模型.L-精氨酸组,模型制备后经股静脉给予L-精氨酸(250 mg/kg),各组建立模型后分别于24 h处死动物并收集标本.酶联免疫吸附法(ELISA)测定肺组织匀浆及支气管肺泡灌洗液(BALF)中IL-17含量.测定肺组织髓过氧化物酶(MPO)活性.结果:与对照组比较,模型组大鼠肺组织匀浆及BALF中IL-17含量均显著升高(P<0.01);模型组肺组织IL-17、肺组织髓过氧化物酶(MPO)活性与L-精氨酸组比较明显偏高(P<0.05).结论:IL-17在大鼠肺挫伤中显

  6. 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

    OpenAIRE

    Thiago Domingos Corrêa; Rogério da Hora Passos; Danilo Teixeira Noritomi; Evandro José de Almeida Figueiredo; Antonio Capone Neto

    2007-01-01

    JUSTIFICATIVA E OBJETIVOS: A contusão miocárdica está freqüentemente associada ao trauma torácico fechado. Seu correto diagnóstico é um constante desafio aos profissionais que trabalham em unidades de emergência, devido aos seus sintomas inespecíficos e a ausência de exames subsidiários com precisão para fazer o diagnóstico. Dentre os diversos métodos diagnósticos estudados, tem-se destacado nos últimos anos o papel dos indicadores de necrose miocárdica troponina I e troponina T. Por serem pr...

  7. Left ventricle short axis two-dimensional strain in pigs with myocardial contusion measured by speckle tracking imaging echocardiography%超声斑点追踪技术对猪心肌挫伤前、后左室短轴二维应变的研究

    Institute of Scientific and Technical Information of China (English)

    袁彬彬; 张卫达; 张雪花; 王晓武

    2012-01-01

    目的:运用斑点追踪技术(STI)测量猪闭合性心肌挫伤前、后左心室短轴各节段的二维应变值,观察正常人室壁二维应变的规律,探讨斑点追踪技术对节段性心肌缺血的临床应用价值.方法:采用小型撞击器对9只贵州小型巴马猪进行撞击建立闭合性心肌损伤模型,记录猪撞击前及撞伤后左室短轴观3个水平的高帧频图像,应用二维应变分析软件测量各节段的径向应变(RS)、圆周应变(CS).结果:闭合性心肌挫伤前Rs在同一水平各节段间差异无统计学意义,乳头肌水平显著高于心尖水平(P<0.05);Cs在同一水平不同节段间差异有统计学意义(P<0.05).闭合性心肌挫伤后的挫伤节段的Rs和Cs显著低于正常组相应节段(均为P<0.01、P<0.05).结论:STI能够准确测量左室短轴各节段的二维应变值、敏感评价心肌缺血程度.%Objective:To evaluate the clinical value of speckle tracking echocardiography for the measurement of two dimensional strain echocardiography (2D-SE) technique in pigs with close myocardial contusion and to estimate the left ventricle function of close myocardial contusion. Methods:9 small Guizhou-Panama pigs were used. The close myocardial contusion animal mode, was snccessfully set up using the small impactor. High frame rate two-dimensional images were recorded from the left ventricular short-axis views at three different levels before and after the MC. Radial strain (RS) and circumferential strain (CS) were measured in the left ventricular short-axis views using 2DS strain analysis software. Results: 2DS analysis software showed that there was no significant difference ( P >0. 05) of the RS at the same levels mentioned above in left ventricle before the MC. RS and CS after the strike were significantly decreased compared with pre-my-ocardial contusion ( P <0. 05. P<0. 01) at the same levels mentioned above in left ventricle. Conclusion: Speckle tracking imaging

  8. Remyelination action of olfactory ensheathing cells in contused spinal cord%嗅球成鞘细胞在挫伤脊髓内的成髓鞘作用

    Institute of Scientific and Technical Information of China (English)

    李越; 刘争; 张洁元; 张路; 段朝霞; 李兵仓

    2014-01-01

    Objective To detect the myelinating role of olfactory ensheathing cells (OECs in the contused spinal cord and their impact on remyelination.Methods The rats were subjected to spinal cord injury at T10(10 g ×25 mm) using a NYU-Ⅱ impactor.One week later,the rats were transplanted with green fluorescence protein (GFP)-OECs (OECs group) or an equal volume of Dulbecco' s modification of Eagle's medium (DMEM) (control group) at epicenter of the injury as well as its rostral and caudal sites.Six weeks after transplantation,the spinal cords were removed for frozen section.Myelin basic protein (MBP),protein zero (P0),and S100 protein (S100) were determined with qualitative and semi-quantitative immunocytochemical assay.Moreover,plastic embedded semithin and ultrathin sections were prepared for qualitative and semi-quantitative examination under light microscopy and electroscopic study of myelin sheath ultrastructure.Results In OECs group,the nerve fibers labeled with S100,MBP,and PO were extended from the normal tissues to the injured region and even grew through the region with space consuming of 12.3%,11.6%,and 9.3% respectively.Moreover,there were no statistical differences regarding the number of fibers labeled by the three proteins,but all were significantly larger than that in control group (2.89%,P < 0.01).Number of myelinated nerve fibers in injured regions on hemithin sections was increased significantly to 354.67 ± 59.00 in OECs group,with significant difference compared with 167.33 ± 42.16 in control group (P < 0.01).The regenerated myelin sheaths in OECs group were smaller and thicker than those in control group.Conclusions OECs can accelerate regeneration of myelinated nerve fibers.Additionally,some OECs form myelin sheaths themselves,but the sheath structures are relatively thinner.%目的 观察嗅球成鞘细胞(olfactory ensheathing cells,OECs)在损伤脊髓内的成髓鞘作用及其对髓鞘形成的影响. 方法 用NYU-Ⅱ

  9. 肺挫伤所致急性呼吸窘迫综合征预后相关因素的Logistic分析%Logistic regression analysis in prognosis of acute respiratory distress syndrome caused by pulmonary contu-sion in adults

    Institute of Scientific and Technical Information of China (English)

    龚顺松; 明炜

    2016-01-01

    目的:探讨肺挫伤所致急性呼吸窘迫综合征患者病死率密切相关的影响因素。方法112例肺挫伤所致急性呼吸窘迫综合征患者的各项临床指标进行统计分析以明确影响病死率的独立相关因素,根据患者预后,分为生存组和死亡组。研究的因素包括性别、年龄、伤后时间、是否合并多发伤、是否发生低血容量性休克、血小板计数、手术与否、血糖值、有无合并基础疾病、ISS 评分及 TSS 评分。应用单因素、多因素 Lo-gistic 回归分析肺挫伤所导致的急性呼吸窘迫综合征。结果两组间性别、手术与否差异无统计学意义(P >0.05),而年龄、伤后时间、低血容量休克、血小板计数、血糖、存在基础疾病、ISS 评分及 TSS 评分差异有统计学意义(P <0.05)。多因素 Logistic 分析发现,影响此类患者预后的独立危险因素为年龄≥60岁、伤后时间、合并多发伤、低血容量休克、血小板计数≤80×109/L、有基础疾病、ISS≥30分和 TSS≥15分。结论肺挫伤所致急性呼吸窘迫综合征病死率高,以上独立危险因素可以为正确判断病情提供重要依据。%Objective To investigate the risk factors of mortality in patients with acute respiratory distress syndrome caused by pulmonary contusion.Methods 112 patients with acute respiratory distress syndrome caused by pulmonary contusion were enrolled in the study,and they were divided into the survival group and the death group ac-cording to their prognosis.The factors relevant to outcomes included age,gender,time after injury,multiple inju-ries,hemorrhagic shock,platelet count,operations,blood sugar,basis diseases,ISS and TSS.All these factors were measured and analyzed by univariate and multivariate logistic regression to form a regression model.Results Univa-riate logistical regression analysis showed that ages,time after injury,multiple injuries,hemorrhagic shock

  10. 大剂量沐舒坦在胸部创伤所致肺挫伤中的应用探讨%Investigation of the Application Effect of Large Dose of Mucosolvin on Pul-monary Contusion Caused by Chest Trauma

    Institute of Scientific and Technical Information of China (English)

    高永河

    2014-01-01

    分析大剂量沐舒坦在胸部创伤所致肺挫伤中的应用效果。方法收集2012年06月—2014年6月该院收治的66例胸部创伤所致肺挫伤患者临床资料,按照不同的剂量方法,将患者分为大剂量组33例、小剂量组33例。两组患者均采取常规综合治疗,大剂量组患者加以大剂量沐舒坦治疗,小剂量组患者加以小剂量沐舒坦治疗,最后分析两组患者的临床治疗效果。结果与小剂量组治疗有效率57.58%对比,大剂量组患者治疗总有效率明显更高为84.85%(P<0.05)。与小剂量组患者肺部感染、肺不张并发症发生率30.30%对比,大剂量组患者并发症发生率明显更低为9.09%(P<0.05)。治疗后,在PaO2、PaCO2、SaO2等指标改善方面,大剂量组患者明显优于对照组(P<0.05)。结论大剂量沐舒坦治疗胸部创伤所致肺挫伤,疗效显著,有利于降低肺部并发症发生率,促进肺功能恢复,值得临床推广。%Objective To analyze the application effect of large dose of mucosolvin on pulmonary contusion caused by chest trau-ma. Methods The clinical data of 66 cases with pulmonary contusion caused by chest trauma admitted in our hospital from June 2012 to June 2014 were selected. The patients were divided into the large dose group and small dose group with 33 cases in each according to the different dose used. Based on the conventional comprehensive treatment, the large dose group was given large dose of mucosolvin and small dose group was given small dose of mucosolvin for treatment. And the clinical treatment effects of the two groups were analyzed. Results The total effective rate of the large dose group was 84.85%, significantly higher than 57.58%of the small dose group(P<0.05). The incidence of complications such as lung infection and atelectasis of the large dose group was 9.09%, much lower than 30.30% of the control group (P<0.05). After treatment, the improvement in PaO2, PaCO2, SaO2 and so

  11. 早期机械通气治疗连枷胸并发急性肺挫伤的疗效评价%Evaluation of the effect of early mechanical ventilation in the treatment of flail chest complicated with acute pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    严四军; 邓波荣; 刘燕; 曹祥; 黄洁健; 乔德成

    2011-01-01

    Objective:To investigate the therapeutic efficacy of mechanical ventilation in the treatment of ilail chest complicated with acute pulmonary contusion. Method:The data of 51 cases suffered of flail chest complicated with acute pulmonary contusion in our hospital from March 2001 to February 2010 were retrospectively analyzed.According to the starting time of mechanical ventilation, the patients were divided into two groups: the early mechanical ventilation group (n = 32) and the later mechanical ventilation group (n = 19). The parameters of blood gas,time of mechanical ventilation, time in intensive care unit(ICU),incidence of complications,and the mortality were compared between the two groups. Result: The degree of respiratory failure of the early mechanical ventilation group was serious than that of the later mechanical ventilation group on admission. However, the degree of respiratory failure of the former was more lightly than that of the latter 24 hours after ventilation(P<0.01). The time of mechanical ventilation and in ICU of the former were obviously shorter than that of the latter,and the incidence of acute respiratory distress syndrome(ARDS) of the former was obviously lower too(P<0.01 ). The incidence of pulmonary infection and multiple organ dysfunction syndrome(MODS) and mortality of the former were lower than those of the latter as well(P<0.05). Conclusion: Early mechanical ventilation on patients suffered from flail chest complicated with acute pulmonary contusion can not only get satisfactory internal fixation but also effectively improve hypoxemia,reduce complications such as ARDS, MODS,shorten the time of mechanical ventilation and the time in ICU,and improve the cure rate.%目的:观察不同时期机械通气对连枷胸并发急性肺挫伤的治疗效果.方法:回顾性分析2001年3月-2010年2月我院收治的51例连枷胸并发肺挫伤患者的临床资料.根据受伤后至实施机械通气的间隔时间分

  12. 肺挫伤患者血清可溶性白细胞分化抗原14、可溶性E选择素、肿瘤坏死因子α水平的变化及意义%Serum Levels of Soluble CD14, Soluble E-Selectin and Tumour Necrosis Factor Alpha in Patients with Pulmonary Contusion

    Institute of Scientific and Technical Information of China (English)

    刘辉; 岳峰涛; 向明; 刘俊钧

    2011-01-01

    目的:观察肺挫伤患者血清可溶性白细胞分化抗原14(soluble CD14,sCD14)、可溶性E选择素(soluble E-selectin,sE-selectin)、肿瘤坏死因子α(tumor necrosis factor-alpha,TNF-α)水平的动态变化及其与伤后肺损伤发展的关系.方法:用酶联免疫吸附试验(ELISA)法检测35例肺挫伤患者伤后6 h、12 h、1 d、3 d、5 d、7 d 血清sCD14、sE-selectin、TNF-α含量及30例健康成人血清中以上3种因子的含量,比较血清中sCD14、sE-selectin、TNF-α含量在肺挫伤患者和健康成人中的差异以及sCD14、sE-selectin、TNF-α与伤后急性肺损伤(ALI)和急性呼吸窘迫综合征(ARDS)的关系.结果:肺挫伤患者伤后6 h血清sCD14、sE-selectin、TNF-α含量即显著升高,且sCD14、sE-selectin含量与ALI和ARDS的发生关系密切,伤后血清sCD14、sE-selectin、TNF-α含量呈显著正相关.结论:血清sCD14、sE-selectin、TNF-α与肺挫伤的发生发展关系密切.%Objective: To study the serum levels of soluble CD14 (sCD14), soluble E-selectin (sE-selectin), tumour necrosis factor alpha (TNF-α) in pulmonary contusion and the relationships between those molecules and subsequent lung injury. Methods: Serum levels of sCD14,sE-selectin,TNF-α were dynamically observed by enzyme linked immunoabsorbed assay (ELISA) in 35 patients with pulmonary contusion 6 h,12 h and 1 d,3 d,5 d,7 d after trauma and in 30 healthy persons from March 2008 to April 2010. Results: Six hours after trauma, sCD14, sE-selectin and TNF-α could be noticed have a significant increase compared with healthy ones. Patients with acute lung injury(ALI) or acute respiratory distress syndrome(ARDS) showed higher sCD14 and sE-selectin concentrations than other patients, sCD14, sE-selectin and TNF-α had significantly positive correlation with each other. Conclusions: sCD14, sE-selectin and TNF-α may play important roles in development and progression of pulmonary contusion.

  13. 复元活血汤加味治疗肺挫伤患者实施优质护理的效果观察%The effect observation of high quality nursing for pulmonary contusion patients treated with Fu Yuan Huo Xue Decoction modified treatment

    Institute of Scientific and Technical Information of China (English)

    李向莉; 张振坤; 周国云; 张艳茹

    2014-01-01

    目的:探讨优质护理在复元活血汤加味治疗肺挫伤的患者中的应用与效果。方法:2011年7月-2013年7月收治肺挫伤患者82例,分为观察组40例和对照组42例。对照组采用传统护理模式,观察组在此基础上采用优质护理服务。结果:观察组对健康教育知识掌握程度明显高于对照组(P<0.01),观察组的满意度明显高于对照组(P<0.05),患者及家属呼叫率明显低于对照组。结论:为患者提供优质的护理服务,既提高了患者和家属的满意度和健康教育知识水平,同时也调动了护理人员的主动性、积极性,融洽了护患关系,取得满意效果。%Objective:To explore the application and effect of high quality nursing for pulmonary contusion patients treated with Fu Yuan Huo Xue Decoction modified treatment.Methods:82 patients with pulmonary contusion were selected from July 2011 to July 2013.They were divided into the observation group with 42 cases and the control group with 40 cases.The control group were given traditional nursing mode,and the observation group were given high quality nursing service on the basis of this.Results:In the observation group,master degree of the health education knowledge was significantly higher than that in the control group;the difference was statistically significant(P<0.01).The satisfaction was significantly higher than that in the control group;the difference was statistically significant(P<0.05).The call rate of patients and their family members was significantly lower than that in the control group.Conclusion:Providing quality care for patients improves both the patient and family satisfaction and health education level,but also mobilizes the initiative and enthusiasm of the nursing staff,and improves the nurse patient relationship.The effect is satisfactory.

  14. Effect of Xuebijing Injection on Vascular Endothelial Growth Factor in Peripheral Blood in Patients with Severe Pulmonary Contusion%血必净注射液对严重肺挫伤患者外周血中血管内皮生长因子的影响

    Institute of Scientific and Technical Information of China (English)

    韩冬; 黄伟

    2014-01-01

    Objective To observe the effect of Xuebijing injection on vascular endothelial growth factor ( VEGF) in peripheral blood in patients with severe pulmonary contusion. Methods A total of 65 patients with severe pulmonary contusion in the Third People's Hospital of Wuxi during September 2011 and January 2014 were randomly di-vided into observation group ( n=31 ) and control group ( n=34 ) . The control group received routine comprehensive treatment. Based on the routine comprehensive treatment, the observation group was treated with 50 ml Xuebijing injec-tion diluted with 100 ml of physiological saline twice a day, and one course of treatment was 7 d. The serum VEGF levels were detected on 1st d, 3rd d, 5th d and 7th d after injuries by enzyme linked immunosorbent assay (ELISA)respectively, and related clinical indexes in the two groups were compared. Results The serum VEGF level changed dynamically in observation group, and it decreased gradually on 1st d after injury. Compared with those in control group, the differences of VEGF levels on 3rd d, 5th d and 7th d after injuries were statistically significant (P  观察组血清VEGF含量呈动态变化,伤后第1天开始逐渐下降,与对照组相比,在第3、5、7天的差异均有统计学意义(P<0.01)。观察组全身炎症反应综合征(SIRS)发生率、机械通气率和病死率均显著低于对照组(P<0.05),机械通气时间、住院时间也均显著短于对照组(P<0.05)。结论血必净注射液能够降低严重肺挫伤患者外周血中VEGF水平,从而减轻VEGF高表达所带来的肺损伤,明显改善预后,值得临床推广应用。

  15. Ligustrazine prevents lung cell apoptosis in the acute stage of pulmonary contusion induced by blunt chest trauma%川芎嗪干预钝性肺挫伤急性期大鼠肺组织细胞的凋亡*

    Institute of Scientific and Technical Information of China (English)

    曹晨; 邓应忠; 郑明安; 刘芳; 孟庆涛

    2013-01-01

      背景:急性胸部撞击后所致的肺挫伤(钝性肺挫伤)常引起呼吸功能异常和继发性炎性反应,并参与全身炎性反应综合征和多器官功能障碍综合征,其发病原因及致病机制亟待明确。目的:观察胸部撞击所致钝性肺挫伤急性期细胞凋亡的变化及其川芎嗪对其的影响。方法:健康雄性 SD 大鼠随机分为正常对照组、模型组、川芎嗪治疗组,后两组制备胸部撞击伤模型,川芎嗪治疗组建模后立即腹腔注射川芎嗪80 mg/kg 1次。在创伤发生后1,2,3 h 观察肺组织病理形态学及细胞凋亡的改变、检测肺水肿程度和肺血管通透性改变,免疫组织化学检测肺组织 Bcl-2、Bax和 Caspase-3的表达及血液中肿瘤坏死因子α水平变化。结果与结论:模型组肿瘤坏死因子α水平在创伤后1 h 即显著增加,创伤后2 h 及3 h 间急剧增加(P <0.05);创伤后2 h 及3 h 肺组织细胞凋亡指数及肺组织损伤程度显著增高(均 P <0.05);肺血管通透性及肺水肿程度增加(P <0.05);Caspase-3表达显著增高(P <0.05),Bcl-2/Bax 比值显著降低(P <0.05)。川芎嗪治疗组在相应时间点相对于模型组肿瘤坏死因子α水平显著降低(P <0.05),肺组织内细胞凋亡指数及肺组织损伤程度降低(P <0.05),肺血管通透性及肺水肿程度减轻(P <0.05);Caspase-3表达下降(P <0.05),Bcl-2/Bax 比值增加(P <0.01)。结果提示,川芎嗪可通过抑制肿瘤坏死因子α表达,下调 Caspase-3的表达并提高 Bcl-2/Bax 的比值,以降低胸部撞击所致肺组织急性期的异常凋亡并减轻胸部撞击所致急性期肺挫伤。%BACKGROUND: Pulmonary contusion induced by blunt chest trauma can result in respiratory dysfunction and secondary inflammatory reaction, which can take part in the occurrence of systemic inflammatory response syndrome and multiple-organ dysfunction syndrome. However, the reason and mechanism

  16. 应变及应变率的速度向量成像定量分析诊断猪心肌挫伤%Diagnosis of Early Myocardial Contusion in Pigs by Velocity Vector Imaging and Quantitative Analysis of Strain and Strain Rate

    Institute of Scientific and Technical Information of China (English)

    王小燕; 王莎莎; 李叶阔; 朱贤胜; 程琦; 罗国新

    2010-01-01

    目的 探讨应变(strain,ε)、应变率(strain rate,SR)的速度向量成像(velocity vector imaging,VVI)定量分析对猪心肌挫伤(myocardial contusion,MC)的早期诊断价值.方法 建立8只猪MC模型.分别于撞击前及撞击后0.5、2、4、8 h,采集左室二尖瓣、乳头肌、心尖水平短轴切面VVI动态图像,利用VVI脱机分析软件获得左室短轴各节段径向峰值ε、SR.结果 撞击后MC节段左室径向峰值ε及SR测值低于撞击前(P<0.05),损伤节段的径向峰值ε及SR测值低于非损伤节段(P<0.05).结论 VVI技术能够定量评价MC后室壁运动异常,为MC早期诊断提供了新方法.

  17. 开放侧裂池、基底池治疗外侧裂区对冲性脑挫伤的疗效观察%Observations on the Effects of Opening Side Crack Pool and Basal Cistern for the Treatment of Lateral Fissure Hedge Brain Contusion

    Institute of Scientific and Technical Information of China (English)

    陈永汉; 贾林伟; 张刚

    2014-01-01

    Objective To investigate the therapeutic effect of the lateral fissure opened intraoperative cerebral con-tusion sylvian cistern , basal cistern for improving the cerebral vasospasm. Methods A total of 106 patients with cerebral contusion in lateral fissure area were randomly divided into 2 groups. The control group was given conventional craniotomy to clear focal cerebral contusion of hematoma. And the experimental group was further to fully open sylvian cistern, jugular vein pool, endplate pool and basal cistern on the basis of the conventional craniotomy to remove the brain contusion and hemato-ma. The levels of endothelin 1 (ET-1) in plasma and cerebrospinal fluid (CSF) were detected postoperative 3, 7 and 14 days. The Glasgow coma scale (GCS) score, ICU guardianship time and total length of hospital stay were observed on discharge and followed up for 3 months in two groups. The rate of good prognosis was compared between two groups. Results There were significant differences in ET-1 levels of plasma and CSF at different time points (plasma Ftime = 603.436 and CSF Ftime =684.276 ) between two groups of patients (plasma Fgroup=272.531 and CSF Fgroup=317.641). The ET-1 levels were signifi-cantly lower after 7 d and 14 d treatment in experimental group, but no significant difference 3d after operation between two groups (P<0.01). The GCS score was significantly higher on discharge in experimental group than that of control group. The values of ICU guardianship time and the total hospitalization time were both significantly lower in experimental group than those of control group (P<0.01). The rate of good prognosis was significantly higher in experimental group than that of con-trol one [78.85%(41/52) vs 51.85%(28/54),χ2=8.496, P<0.01]. Conclusion Openning side crack pool and basal cistern in the surgical treatment of traumatic brain injury can improve the cerebral vasospasm and prognosis.%目的:探讨外侧裂区脑挫伤术中开放侧裂池、基底池治

  18. ω-3 fish oil fatty emulsion effect on patients with pulmonary contusion together with pneumonia%肠外应用ω-3鱼油脂肪乳对肺挫伤合并肺炎的疗效观察

    Institute of Scientific and Technical Information of China (English)

    赵凯峰; 王华荣; 滑立伟; 段立娟; 夏嘉鼎

    2012-01-01

    Objective To observe the effect of co -3 fish oil fatty emulsion in patients with pulmonary contusion together with pneumonia. Methods Patients who got respiratory failure (oxygenation index <300) were divided into two groups randomly (the control group and the treated group). The control group were given the treatment including mechanical ventilation.anti-infection and nutritional support.The treated group were treated with co-3 fish oil fatty emulsion(100ml,qd,ivgtt,5~7 days) besides general treatment. Then we observe the differences between the two groups about the treating time in ICU,duration of ventilation,the time of using antibiotic and the ARDS incidence rate. Results The time in ICU.duration of ventilation.the time of using antibiotic and the ARDS incidence rate in treated group is obviously lower than that in control group. Conclusion It is effective adjunctive therapy to use co-3 fish oil fatty emulsion to assist in treating patients with pulmonary contusion together with pneumonia, which could decurtate the time in ICU ,the duration of mechanical ventilation.the time of using antibioti and decrease the ARDS incidence rate significantly.%目的:观察ω-3鱼油脂肪乳对肺挫伤合并肺炎的治疗效果.方法:患者为肺挫伤合并肺炎,均存在呼吸衰竭,氧合指数<300,随机分为鱼油脂肪乳治疗组和对照组,对照组采用机械通气、抗感染、营养支持等常规治疗,治疗组在常规治疗基础上加用ω-3鱼油脂肪乳剂100ml每天一次静脉滴注,疗程5~7天,观察患者住ICU天数、机械通气天数、抗生素使用天数、ARDS发生率,并对两组结果进行比较.结果:治疗组在住ICU天数、机械通气天数、抗生素使用天数、ARDS发生率上明显低于对照组(P<0.05).结论:ω-3鱼油脂肪乳对肺挫伤合并肺炎的患者有良好的辅助治疗作用,能够有效缩短住ICU天数、机械通气天数、抗生素使用天数,减少ARDS的发生.

  19. 双额颞部开颅一次成型去大骨瓣减压术治疗双额叶脑挫裂伤临床研究%Clinical study of forming a double frontotemporal craniotomy and removing large decompressive craniectomy to treat dual frontal brain contusion

    Institute of Scientific and Technical Information of China (English)

    邓光策; 王岳华; 姚兴军; 侯文仲; 曾敏敏; 关北漩; 李国峰

    2015-01-01

    Objective To investigate the clinical effectiveness of forming a double frontotemporal craniotomy and removing large decompressive craniectomy to treat dual frontal brain contusion.Methods A randomized single‐blind controlled method was used. Treatment group (TG ,n=47) removed the whole craniectomy ,ligated the superior sagittal sinus and cut the whole falx.Control group (CG ,n=46) conventionally retained osteopontin and did not cut falx. The treatment efficacies of the two groups were observed.Results In TG ,23 cases were good recovery ,13 cases were moderate disability ,2 cases were severe disability ,3 cases were persistent vegetative ,6 cases were deaths;in CG ,15 cases were good recovery ,10 cases were moderate disability ,7 cases were severe disability ,6 cases were persistent vegetative ,8 cases were deaths. These were significantly bet‐ter in TG than CG (P<0.05). Especially ,it was significant better for clinical effect in the moderate to severe patients with short‐term treatment in TG than that of CG ( P < 0.01 ) . Conclusion T his is an affirmation and security surgical treatment for the patients with dual frontal lobe contusion symptoms ,and it also has fewer complications.%目的:探讨双额颞部开颅一次成型去大骨瓣减压术治疗双额叶脑挫裂伤的临床效果。方法采用随机单盲对照法,治疗组在手术时整块去除骨瓣、结扎矢状窦并完全剪开大脑镰,对照组采用常规保留骨桥但不剪开大脑镰,观察治疗效果。结果治疗组恢复良好23例,中度残疾13例,重度残疾2例,植物生存3例,死亡6例;对照组恢复良好15例,中度残疾10例,重度残疾7例,植物生存6例,死亡8例,治疗组明显优于对照组(P<0.05),且对中重度患者短期临床效果显著(P<0.01)。结论该术式治疗双额叶脑挫裂伤患者症状的临床疗效肯定,安全且并发症少。

  20. 双额叶重度脑挫裂伤并发中央型脑疝的早期救治观察和预后分析%Early treatment of central herniation observation and prognosis of dual frontal concurrent severe cerebral contusion

    Institute of Scientific and Technical Information of China (English)

    李东; 袁素萍

    2014-01-01

    目的:探讨双额叶重度脑挫裂伤并发中央型脑疝的早期治疗效果。方法选取双额叶重度脑挫裂伤并发中央型脑疝患者54例,采用随机数字表法分为观察组和对照组,观察组采用早期手术治疗,对照组则不接受手术治疗。比较两组临床疗效及预后。结果经过治疗后,观察组GCS评分(12.98±3.85)分,显著高于对照组的(11.35±4.12)分(t=2.354,P<0.05),观察组ICU时间及总入院时间明显短于对照组(t=10.007,P<0.01;t=19.278,P<0.01);观察组恢复良好率(40.74%)显著高于对照组(14.81%)(χ2=4.523,P<0.05),观察组中残率、重残率、植物生存率及病死率(33.33%、14.81%、7.41%、3.70%)均低于对照组(44.44%、22.22%、11.11%、7.41%),但差异均无统计学意义(χ2=2.587、2.135、2.268、2.189,均P>0.05)。结论对双额叶重度脑挫裂伤并发中央型脑疝患者进行早期诊断,采用手术治疗方法进行开颅减压,能明显提高治愈率,有效改善预后。%Objective To investigate the bilateral frontal cerebral contusion complicated by severe central herniation early treatment .Methods 54 cases of severe bilateral frontal cerebral contusion complicated by central herniation patients were randomly divided into the observation group and control group using number table .The obser-vation group were taken the early surgical treatment and the control group were not underwent surgery .The clinical symptoms and prognosis of treatment were compared .Results After treatment ,the GCS score of the observation group was (12.98 ±3.85),which was higher than (11.35 ±4.12) of the control group(t=2.354,P0.05).Conclusion Dual frontal severe brain injury complicated by central herniation patients with early diagnosis and surgical treatment method using craniotomy decompression can

  1. 参附注射液对肺挫伤患者血浆肿瘤坏死因子及白细胞介素的影响%Effect of shenfu injection on TNF、IL-6、IL-8 in patients with pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    王海文; 宋涛

    2010-01-01

    目的 通过分析参附注射液对肺挫伤患者治疗前后血浆肿瘤坏死因子(TNF)、白细胞介素(IL6、IL-8)水平变化,探讨其对肺挫伤的治疗效果.方法 选择肺挫伤患者110例,随机分组.对照组行常规治疗,治疗组在常规治疗基础上加用参附注射液.检测治疗前后患者血浆TNF、IL-6、IL-8水平.结果 治疗前两组患者肺挫伤评分差异无统计学意义(P>0.05);治疗后治疗组TNF、IL-6、IL-8水平明显降低,与对照组差异有统计学意义(P0.05).Plasma TNF,IL-6,IL-8 levels in the treatnent group significantly reduced compared with control group after treatment(P<0.051.Conclusion Shenfu injection has therapeutic effect on pulmonary contusion,itcan reduce TNF,IL-6,IL-8 levels,antagonize TNF,IL-6,IL-8 of the vasoconstrictive effect,thereby reducing TNF,IL-6,IL-8 caused secondary lung injury,promote the repair of damaged tissue and lung function recovery.

  2. Ventilation-Perfusion Relationships Following Experimental Pulmonary Contusion

    Science.gov (United States)

    2007-06-14

    new method for assessment of pulmo- nary density distributions involving semiautomatic 3-dimensional reconstruction of chest computed tomography (CT...hemorrhage, alveolar edema, inflammation, and necrosis, each graded on a scale of 0 through 4 (0 normal, 1 minimal, 2 mild, 3 moderate, 4...in the left lungs of the injured animals were mild and consisted of patchy ground- glass opacification (Fig. 6). Semiautomatic CT scan analysis

  3. Clinical effect of edaravone combined with nimodipine in the treatment of the non-operative cerebral contusion and laceration%依达拉奉联合尼莫地平治疗非手术脑挫裂伤的疗效观察

    Institute of Scientific and Technical Information of China (English)

    潘泰峰; 赵斌杰; 陈欣; 汪林涛; 徐俊芳

    2012-01-01

    Objective To explore the clinical effect of edaravone combined with nimodipine in the treatment of cerebral contusin and laceration. Methods Ninety-seven patients with the non-operative cerebral contusin and laceration in our hospital from Sep. 2010 to Mar. 2012 were divided into the study group) (n=49) and the control group (n=48). Patients in the control group were treated with nimodipine pumped into the vein, while those in the study group were given edaravone daily in static drops based on the control group. Five days after treatment, the clinical efficacy and clinical neurological defect were scored. CT examinations were performed on the third and fifth day after treatment. The changes in cerebral edema volume were compared between the two groups. Results The clinical efficacy of the study group was significantly better than that in the control group (with the total effective rates 95.9% and 83.3%, respectively, P<0.05). The clinical neurological defect scores were significantly improved in the study group than the control group (t=2.357, P<0.05). The brain edema significantly less serious in the study group (t= 2.436, P<0.05). Conclusion In the treatment of the non-operative cerebral contusion, and laceration, edaravone combined with nimodipine can help clear away free radical, reduce cerebral edema, and improve patients' symptoms and the curative effect.%目的 探讨依达拉奉联合尼莫地平治疗非手术脑挫裂伤的临床疗效.方法 选取我院自2010年9月至2012年3月期间收治的轻、中型为主的非手术脑挫裂伤患者97例,随机分为治疗组49例和对照组48例.对照组常规给予尼莫地平静脉泵入,治疗组在此基础上每日给予依达拉奉静滴,两组治疗5d后进行疗效分析和临床神经功能缺损程度评分.并分别在治疗的第3天和第5天,给予头部CT检查,对两组患者脑水肿的体积变化进行比较.结果 治疗组的疗效明显优于对照组(治疗组总有效率为95.9

  4. Effects of pulsed electromagnetic fields on the expression of MyoD after acute skeletal muscle contusion%脉冲电磁场对大鼠骨骼肌急性挫伤后成肌分化因子D表达的促进作用

    Institute of Scientific and Technical Information of China (English)

    王晶; 张长杰; 顾旭东; 姚云海

    2009-01-01

    目的 观察脉冲电磁场(PEMFs)对大鼠骨骼肌急性挫伤(ASMC)后组织学及成肌调节因子D(MyoD)表达的影响,并探讨脉冲电磁场在大鼠骨骼肌急性挫伤早期治疗中的应用.方法 将42只Sprague-Dawley大鼠随机等分为治疗组(造模+PEMFs干预)、造模对照组(造模)、空白对照组(不予任何处理),每组大鼠14只.治疗组与造模对照组大鼠均选取大鼠左后肢小腿三头肌,采用金属砝码在PVC管引导下垂直下落建立ASMC模型.治疗组造模成功后即刻予以PEMFs干预1次.每组分别在造模成功后第12小时和第18小时随机处死7只大鼠,取小腿三头肌进行HE染色观察,测定MyoD荧光强度.结果 造模对照组在两个时间点均出现胞浆淡染、胞核多形态改变,在治疗组,其程度明显减轻,但较空白对照组严重;治疗组及造模对照组的MyoD荧光强度,第18小时均高于第12小时(P<0.01),且两组在各时间点的表达均高于空白对照组(P<0.01),第18小时,治疗组高于造模对照组(P<0.01).结论 大鼠骨骼肌急性挫伤后早期应用PEMFs,可以在干预后18 h出现MyoD的表达上调,这可能是PEMFs促进骨骼肌再生的机理之一.%Objective To observe the effects of pulsed electromagnetic fields (PEMFs) on histological changes and myogenic differentiation factor D (MyoD) expression in rats with acute skeletal muscle contusion ( ASMC), and to explore the effects of PEMF therapy on rats with ASMC in its very early stages. Methods Forty-two rats were randomly divided into three groups : a treatment group, a control group and a blank control group. ASMC models were established with all the animals in the treatment and control groups. PEMF treatment was admin-istered to the treatment group immediately after the establishment of the ASMC model. Seven rats in each group were sacrificed at the 12th and 18th h after the models were set up. Their triceps surae muscles were sampled and treated with haematoxylin

  5. Diagnostic value of nuron specific enolase and myelin basic protein on patients of early brain contusion and laceration%血清神经元特异性烯醇化酶、S100β蛋白、神经胶质纤维酸性蛋白、髓鞘碱性蛋白在早期脑挫裂伤患者中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    李庆禄; 李光杰; 王文智; 李宁; 李伟

    2014-01-01

    Objective To investigate the diagnostic value of nuron specific enolase( NSE),S100βprotein,glial fibrillary acidic protein( GFAP)and myelin basic protein( MBP)in patients with early brain contusion and laceration. Methods One hundred and twelve cases with brain contusion and laceration diagnosed by CT or MRI were selected as our subjects who hospitalized Harrison international peace hospital from Apr. 2012 to Jul. 2013. Of them,68 cases with mild head injury were served as mild group and 44 cases of severe traumatic brain injury were served as severe group. And 83 healthy people without lung disease and nervous system diseases were served as control group. Electro chemiluminescence assay and ELISA methods were used to measure the level of NSE,S100β,GFAP,MBP. Results the level of serum NSE,S100β protein,GFAP and MBP in mild group were(18. 14 ± 6. 83),(0. 92 ± 0. 45),(0. 78 ± 0. 37))(4. 37 ± 1. 84)μg/ L,respectively, and(32. 11 ± 12. 48),(1. 58 ± 0. 94),(4. 26 ± 1. 96),(14. 72 ± 6. 77)μg/ L,respectively in severe group, and(8. 94 ± 3. 49),(0. 12 ± 0. 08),(0. 13 ± 0. 09),(1. 98 ± 0. 89)μg/ L,respectively in control group. There were significant differences among three groups( F = 137. 520,120. 083,283. 727,205. 569 respectively;P< 0. 01). All indexes were different between control and mild groups( q = 10. 599,13. 296,5. 881,6. 018;P< 0. 01),as well as between the mild and severe groups(q = 13. 600,9. 249,26. 639,22. 029;P < 0. 01),and between control and severe group(q = 23. 408,21. 258,32. 797,28. 134;P < 0. 01). Conclusion The level of serum NSE,S100β,GFAP,MBP can be used as early indicators of brain injury secondary diagnosis and secondary index for evaluating damage degree.%目的:探讨血清神经元特异性烯醇化酶( NSE)、S100β蛋白、神经胶质纤维酸性蛋白(GFAP)、髓鞘碱性蛋白(MBP)联合检测在早期脑挫裂伤患者诊断中的价值。方法研究对象来源于我院2012年4月至2013年7

  6. Electronic Vapor Cigarette Battery Explosion Causing Shotgun-like Superficial Wounds and Contusion

    Directory of Open Access Journals (Sweden)

    Siri Shastry, MD

    2016-03-01

    Full Text Available INTRODUCTION Electronic vapor cigarettes (E-cigarettes were created in 2003 as an alternative to traditional tobacco cigarettes. E-cigarettes have been available in the United States since 2006.1 The typical E-cigarette consists of a cartridge that contains liquid, an atomizer that heats the liquid (i.e. acts as a vaporizer, as well as a battery. The liquid contained within the cartridge contains nicotine, propylene glycol and/ or glycerol as well as flavorings. The consumer uses an E-cigarette through either pushing a button or inhalation, which triggers heating and therefore aerosolizes the liquid within the cartridge, emulating cigarette “smoke.” The newest E-cigarettes are larger than nicotine cigarettes and employ stronger, rechargeable batteries as a power source.2,3

  7. Gun Shot to Thorax Resulting in Localized Hemothorax and Lung Contusion

    Science.gov (United States)

    2009-12-01

    VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to...RESPONSIBLE PERSON a. REPORT unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI... costo -phrenic space. Fig. 2 Axial CTA (CT Angiogram) of upper thorax. Note fluid attenuation in close proximity to the contrast filled left

  8. Chondroitinase gene therapy improves upper limb function following cervical contusion injury

    NARCIS (Netherlands)

    James, Nicholas D; Shea, Jessie; Muir, Elizabeth M; Verhaagen, J.; Schneider, Bernard L; Bradbury, Elizabeth J

    2015-01-01

    Chondroitin sulphate proteoglycans (CSPGs) are known to be important contributors to the intensely inhibitory environment that prevents tissue repair and regeneration following spinal cord injury. The bacterial enzyme chondroitinase ABC (ChABC) degrades these inhibitory molecules and has repeatedly

  9. Effect of fetal spinal cord graft with different methods on axonal pathology after spinal cord contusion

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the effect of fetal spinal cord (FSC) graft with different methods on axonal pathology and neurological function recovery after spinal cord injury (SCI).   Methods: Forty Wistar rats were divided into 4 groups. In Group A, the spinal cord was injured and hemisected. In Group B, fetal spinal cord (FSC) was transferred into the injured site. In Group C, after having done as Group B, the upper and lower spinal nerve roots were anastomosed. And in Group D, after having done as Group B, the pedicled omentum was transferred into the hemisection cavity. At 6 weeks after operation, light and electronic microscopes were used to examine the axonal pathology. The neurological function was assessed with inclined plane tests in the open field. The number of axons was quantitated by a computer image analysis system.   Results: A greater loss of axons was observed in Group A than that of other groups at 6 weeks. The sequence of the reduced rate of the axons was as following, Group A>Group B>Group C>Group D (P<0.05). The remaining axons were paralleled with the significant improvement in neurological function recovery of the rats.   Conclusions: It indicates that FSC and pedicled omentum grafts after SCI can protect the axons and promote the neurological function recovery of the rats.

  10. Positron emission tomography for serial imaging of the contused adult rat spinal cord.

    NARCIS (Netherlands)

    Nandoe, R.D.S.; Yu, J.; Seidel, J.; Rahiem, S.T.; Hurtado, A.; Tsui, B.M.; Grotenhuis, J.A.; Pomper, M.G.; Oudega, M.

    2010-01-01

    We investigated whether small-animal positron emission tomography (PET) could be used in combination with computed tomography (CT) imaging techniques for longitudinal monitoring of the injured spinal cord. In adult female Sprague-Dawley rats (n = 6), the ninth thoracic (T9) spinal cord segment was e

  11. Dynamic Changes in Shunt and Ventilation-Perfusion Mismatch Following Experimental Pulmonary Contusion

    Science.gov (United States)

    2010-04-01

    sustained tachycardia and transient hypotension. Partial pressure of arterial oxygen ( PaO2 ) decreased from 83.9 T 4.2 mmHg at baseline to 51.3 T 2.8...the MIGET because the arterial PaO2 predicted by the traffic of the inert gases can be compared with the measured PaO2 . If DL is present, the PaO2 ...predicted by the MIGET techniques from Va/Q inequality and shunt will systematically exceed the measured PaO2 . TEG and coagulation analyses TEG tests were

  12. Severe lung contusion and death after high-velocity behind-armor blunt trauma: relation to protection level.

    Science.gov (United States)

    Gryth, Dan; Rocksén, David; Persson, Jonas K E; Arborelius, Ulf P; Drobin, Dan; Bursell, Jenny; Olsson, Lars-Gunnar; Kjellström, Thomas B

    2007-10-01

    The most-used safety recommendation for protective vests is that the impact should not cause more than a 44-mm impression in plasticine. The aim of this study was to investigate whether this criterion was sufficient if the vest was exposed to a high-velocity projectile. We tested the hypothesis with pigs divided into a 40-mm group (n = 10) and a 34-mm group (n = 8) protected by a vest allowing a 40-mm or 34-mm impression in plasticine, respectively. Five (50%) of 10 animals in the 40-mm group and 2 (25%) of 8 in the 34-mm group died due to the trauma. We observed severe lung hematoma, impaired circulation, desaturation, and electroencephalogram changes. These effects were more aggravated in the 40-mm group compared to the 34-mm group. Based on our results, the overall judgment is that the safety criterion of 44-mm impression is insufficient when a vest is exposed to a high-velocity projectile.

  13. 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.)

  14. 肺挫伤研究现状及治疗%Present study of pulmonary contusion and its treatment

    Institute of Scientific and Technical Information of China (English)

    徐志飞; 刘军强

    2005-01-01

    肺挫伤是主要的胸部钝性伤,严重肺挫伤死亡率较高,是胸部创伤的主要死亡原因之一.笔者收集了近几年有关肺挫伤基础研究及临床救治的文献报道,对肺挫伤后的病理生理、影像学研究及治疗进展作了重点介绍.

  15. Advances in diagnosis and treatment of pulmonary contusion%肺挫伤的诊治进展

    Institute of Scientific and Technical Information of China (English)

    张正富; 都定元; 向小勇

    2009-01-01

    探讨肺挫伤的发生机制、病理生理改变、临床表现、诊断及治疗方法的最新进展.熟练掌握肺挫伤的诊治原则,对降低病死率及改善预后具有极其重要的意义.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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

    OBJECTIVE: Currently, cellular transplantation for spinal cord injuries (SCI) is the subject of numerous preclinical studies. Among the many cell types in the adult brain, there is a unique subpopulation of neural stem cells (NSC) that can self-renew and differentiate into neurons. The study aims......, 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...... was confirmed by magnetic resonance imaging (MRI) and histological analysis. Animals were clinically observed for 6 months. RESULTS: Analysis confirmed homing of mNSCs into the injury site. Transplanted cells expressed neuronal markers (TubIII). Hind limb performance improved in trans- planted animals based...

  18. Olfactory ensheathing cells (OECs) degrade neurocan in injured spinal cord by secreting matrix metalloproteinase-2 in a rat contusion model.

    Science.gov (United States)

    Yui, Sho; Fujita, Naoki; Chung, Cheng-Shu; Morita, Maresuke; Nishimura, Ryohei

    2014-11-01

    The mechanism by which olfactory ensheathing cells (OECs) exert their potential to promote functional recovery after transplantation into spinal cord injury (SCI) tissue is not fully understood, but the relevance of matrix metalloproteinases (MMPs) has been suggested. We evaluated the expression of MMPs in OECs in vitro and the MMP secretion by OECs transplanted in injured spinal cord in vivo using a rat SCI model. We also evaluated the degradation of neurocan, which is one of the axon-inhibitory chondroitin sulfate proteoglycans, using SCI model rats. The in vitro results showed that MMP-2 was the dominant MMP expressed by OECs. The in vivo results revealed that transplanted OECs secreted MMP-2 in injured spinal cord and that the expression of neurocan was significantly decreased by the transplantation of OECs. These results suggest that OECs transplanted into injured spinal cord degraded neurocan by secreting MMP-2.

  19. Modulation of ankle EMG in spinally contused rats through application of neuromuscular electrical stimulation timed to robotic treadmill training.

    Science.gov (United States)

    Askari, Sina; Kamgar, Parisa; Chao, TeKang; Diaz, Eric; de Leon, Ray D; Won, Deborah S

    2012-01-01

    While neuromuscular electrical stimulation (NMES) has enabled patients of neuromotor dysfunction to effectively regain some functions, analysis of neuromuscular changes underlying these functional improvements is lacking. We have developed an NMES system for a rodent model of SCI with the long term goal of creating a therapy which restores control over stepping back to the spinal circuitry. NMES was applied to the tibialis anterior (TA) and timed to the afferent feedback generated during robotic treadmill training (RTT). The effect of NMES+RTT on modifications in EMG was compared with that of RTT alone. A longitudinal study with a crossover design was conducted in which group 1 (n=7) received 2 weeks of RTT only followed by 2 weeks of NMES+RTT; group 2 (n=7) received 2 weeks of NMES+RTT followed by RTT only. On average, both types of training helped to modulate TA EMG activity over a gait cycle, resulting in EMG profiles across steps with peaks occurring just before or at the beginning of the swing phase, when ankle flexion is most needed. However, NMES+RTT resulted in concentration of EMG activation during the initial swing phase more than RTT only. In conjunction with these improvements in EMG activation presented here, a more complete analyses comparing changes after NMES+RTT vs. RTT is expected to further support the notion that NMES timed appropriately to hindlimb stepping could help to reinforce the motor learning that is induced by afferent activity generated by treadmill training.

  20. Study of VEP and ERG in ocular contusion%眼挫伤VEP、ERG联合检查的意义

    Institute of Scientific and Technical Information of China (English)

    仪立群

    2003-01-01

    目的探讨VEP、ERG在眼挫伤中应用的意义.方法对我院近3年来无屈光间质障碍的眼挫伤患者68例68眼,除行常规视力、裂隙灯和眼底检查外,予行VEP、ERG检查.结果对伤后视力下降,矫正不佳,常规检查又未能查出明显异常者,VEP或ERC均有异常.结论VEP、ERG联合应用是眼挫伤后早期诊断及视功能评价的客观检测手段.

  1. Surgical Treatment for Occipital Condyle Fracture, C1 Dislocation, and Cerebellar Contusion with Hemorrhage after Blunt Head Trauma

    Directory of Open Access Journals (Sweden)

    Shigeo Ueda

    2016-01-01

    Full Text Available Occipital condyle fractures (OCFs have been treated as rare traumatic injuries, but the number of reported OCFs has gradually increased because of the popularization of computed tomography (CT and magnetic resonance imaging (MRI. The patient in this report presented with OCFs and C1 dislocation, along with traumatic cerebellar hemorrhage, which led to craniovertebral junction instability. This case was also an extremely rare clinical condition in which the patient presented with traumatic lower cranial nerve palsy secondary to OCFs. When the patient was transferred to our hospital, the occipital bone remained defective extensively due to surgical treatment of cerebellar hemorrhage. For this reason, concurrent cranioplasty was performed with resin in order to fix the occipital bone plate strongly. The resin-made occipital bone was used to secure a titanium plate and screws enabled us to perform posterior fusion of the craniovertebral junction. Although the patient wore a halo vest for 3 months after surgery, lower cranial nerve symptoms, including not only neck pain but also paralysis of the throat and larynx, improved postoperatively. No complications were detected during outpatient follow-up, which continued for 5 years postoperatively.

  2. Radiology corner. Answer to last month's radiology case (#26) and image: Lung laceration with loculated blood, active bleeding, contusion and hemothorax.

    Science.gov (United States)

    Backus, Christopher; Folio, Les

    2008-08-01

    The following case demonstrates the importance of emergent imaging in victims of gunshot wound to the chest. The AP chest in our case highlights findings that correlate well with support of follow up CT Angiogram of the chest. This case also exemplifies description of complex planes now available with modern CT imaging capabilities described here as para-axial, para-coronal and para-sagittal reconstructions.

  3. 老年人肺挫伤58例临床分析%Clinical analysis of 58 gerontal patients with pulmonary contusions

    Institute of Scientific and Technical Information of China (English)

    周烨强; 李校传

    2000-01-01

    报告年龄60岁以上老年人肺挫伤58例,其中死亡6例,死亡率10.3%,其余均治愈.分析结果表明,尽早明确诊断,处理合并伤,积极应用呼吸机,合理应用抗生素及防治并发症是救治成功的关键.

  4. 连枷胸与肺挫伤的临床诊治%Clinical diagnosis and treatment of traumatic flail chest and pulmonary contusion

    Institute of Scientific and Technical Information of China (English)

    闵家新

    2008-01-01

    钝性胸部创伤是交通事故中的常见伤类,无论平时或战时,钝性胸部创伤在创伤中都占有非常重要的地位.本文对近年来钝性胸部创伤的有关诊断手段进行了分析和总结,特别对临床常见的连枷胸和肺挫伤的伤情特点和治疗作了重点介绍.

  5. Treatment effect of ventilation with diuretic on contusion patents%机械通气及利尿剂治疗肺挫伤21例

    Institute of Scientific and Technical Information of China (English)

    金晓玲; 杜叶平

    2005-01-01

    目的探讨机械通气和利尿剂治疗肺挫伤的临床应用价值.方法对21例肺挫伤患者采用呼吸机正压通气和使用利尿剂后,观察治疗前后血气分析变化.结果治疗后PaO2及SaO2均明显升高,差异有显著性(P<0.01).结论呼吸机正压通气和利尿剂治疗肺挫伤疗效满意.

  6. Large-scale chondroitin sulfate proteoglycan digestion with chondroitinase gene therapy leads to reduced pathology and modulates macrophage phenotype following spinal cord contusion injury

    NARCIS (Netherlands)

    Bartus, Katalin; James, Nicholas D; Didangelos, Athanasios; Bosch, Karen D; Verhaagen, J.; Yáñez-Muñoz, Rafael J; Rogers, John H; Schneider, Bernard L; Muir, Elizabeth M; Bradbury, Elizabeth J

    2014-01-01

    Chondroitin sulfate proteoglycans (CSPGs) inhibit repair following spinal cord injury. Here we use mammalian-compatible engineered chondroitinase ABC (ChABC) delivered via lentiviral vector (LV-ChABC) to explore the consequences of large-scale CSPG digestion for spinal cord repair. We demonstrate si

  7. Emergency diagnosis of severe myocardial contusion%重度心肌挫伤急诊诊断方法的探讨

    Institute of Scientific and Technical Information of China (English)

    周洋; 吴远林; 向小勇; 赵兴吉

    2008-01-01

    目的:探讨重度心肌挫伤的急诊诊断方法.方法:对30例严重钝性胸部创伤患者分别在伤后1、2,4、8 h行心肌标志物检测和超声心动图检查.结果:伤后8 h肌钙蛋白T(Cardiac troponin T,cTn-T)和肌钙蛋白I(Ca-iac troponin I,cTn-I)均明显高于伤后1 h,伤后左心室心功能部分指标有明显改变.结论:心肌标志物联合超声检查对重度心肌挫伤有较高的急诊诊断价值.

  8. VEP、F-ERG在眼挫伤中应用研究%Study of the VEP and F- ERG in apply of ocular contusion

    Institute of Scientific and Technical Information of China (English)

    丁莹; 张鑫; 付玉兰; 李芙蓉

    2001-01-01

    目的视觉诱发电位(VEP)和闪光视网膜电图(F-ERG)联合应用评价钝挫伤眼的视功能.方法86例(86眼)钝挫伤眼及健康对侧眼为对照组,按照国际标准分别行VEP和F-ERG检查.比较分析两组间VEP P100波潜时值、F-ERG的a、b波幅值的平均值.结果眼挫伤组VEP P100波潜时明显延迟,波幅值明显降低;F-ERG a、b波幅值明显降低,其异常率随视功能损伤程度的加重而增加.结论VEP和F-ERG联合应用是评价眼挫伤视功能及早期确定诊断的客观检测手段.

  9. The transcriptional response of neurotrophins and their tyrosine kinase receptors in lumbar sensorimotor circuits to spinal cord contusion is affected by injury severity and survival time.

    Directory of Open Access Journals (Sweden)

    M Tyler Hougland

    2013-01-01

    Full Text Available Traumatic spinal cord injury (SCI results in changes to the anatomical, neurochemical, and physiological properties of cells in the central and peripheral nervous system. Neurotrophins, acting by binding to their cognate Trk receptors on target cell membranes, contribute to modulation of anatomical, neurochemical, and physiological properties of neurons in sensorimotor circuits in both the intact and injured spinal cord. Neurotrophin signaling is associated with many post-SCI changes including maladaptive plasticity leading to pain and autonomic dysreflexia, but also therapeutic approaches such as training-induced locomotor improvement. Here we characterize expression of mRNA for neurotrophins and Trk receptors in lumbar dorsal root ganglia (DRG and spinal cord after two different severities of mid-thoracic injury and at 6 and 12 weeks post-SCI. There was complex regulation that differed with tissue, injury severity, and survival time, including reversals of regulation between 6 and 12 weeks, and the data suggest that natural regulation of neurotrophins in the spinal cord may continue for months after birth. Our assessments determined that a coordination of gene expression emerged at the 12 week post-SCI time point and bioinformatic analyses address possible mechanisms. These data can inform studies meant to determine the role of the neurotrophin signaling system in post-SCI function and plasticity, and studies using this signaling system as a therapeutic approach.

  10. Efeitos do ultra-som terapêutico nas propriedades mecânicas do músculo esquelético após contusão Effects of therapeutic ultrasound on the mechanical properties of skeletal muscles after contusion

    Directory of Open Access Journals (Sweden)

    JPC Matheus

    2008-06-01

    Full Text Available CONTEXTUALIZAÇÃO: O ultra-som terapêutico (UST é um recurso comumente aplicado na aceleração do reparo tecidual de lesões musculares. A absorção das ondas ultra-sônicas é determinada pela freqüência e pela intensidade, sendo que, em uma mesma intensidade, a profundidade atingida por 1MHz é maior quando comparada a 3MHz. OBJETIVO: Analisar o comportamento das propriedades mecânicas de músculos submetidos à lesão aguda por impacto e tratados com UST, utilizando as freqüências de 1 e 3MHz. MATERIAIS E MÉTODOS: Foram utilizadas 40 ratas Wistar (200,1±17,8g, divididas em quatro grupos: (1 controle; (2 lesão muscular sem tratamento; (3 lesão muscular tratada com UST de freqüência 1MHz (0,5W/cm² e (4 lesão muscular tratada com UST de freqüência 3MHz (0,5W/cm². A lesão foi provocada no músculo gastrocnêmio por mecanismo de impacto. O tratamento foi de cinco minutos diários durante seis dias consecutivos. Os músculos foram submetidos a ensaios mecânicos de tração em uma máquina universal de ensaios. RESULTADOS: As médias e desvios-padrão das propriedades mecânicas dos grupos lesionados e tratados com UST foram significativamente maiores quando comparadas ao grupo lesionado sem tratamento (pBACKGROUND: Therapeutic ultrasound is a resource commonly applied to speed up tissue repair in muscle injuries. The absorption of the ultrasound waves is determined by their frequency and intensity. For a given intensity, the depth reached by 1MHz is greater than the depth reached by 3MHz. OBJECTIVE: To analyze the mechanical properties of muscles subjected to acute impact injury treated with therapeutic ultrasound at the frequencies of 1 and 3MHz. METHODS: Forty female Wistar rats (200.1±17.8g were used, divided into four groups: (1 control; (2 muscle injury without treatment; (3 muscle injury treated with therapeutic ultrasound at the frequency of 1MHz (0.5W/cm²; and (4 muscle injury treated with therapeutic ultrasound at the frequency of 3MHz (0.5W/cm². The injury was produced in the gastrocnemius muscle by means of an impact mechanism. The treatment consisted of a single five-minute session per day, for six consecutive days. The muscles were subjected to mechanical traction tests in a universal test machine. RESULTS: Means and standard deviations for the mechanical properties of the injured groups that received therapeutic ultrasound were significantly greater than those of the injured group without treatment (p<0.05. The property of stiffness should be highlighted: the application of therapeutic ultrasound increased muscle stiffness by approximately 38%. CONCLUSIONS: Therapeutic ultrasound increased the mechanical properties of the injured muscles, and brought them to a level close to the control group. However, no significant difference in mechanical properties was observed between the groups treated with ultrasound at the frequencies of 1MHz and 3MHz.

  11. The expressions of BDNF and TrkB in rat retina after contusion strike%大鼠眼挫伤后视网膜BDNF及其受体TrkB的表达

    Institute of Scientific and Technical Information of China (English)

    肖寿华; 张志坚; 邵倩; 杨勇; 缪竞诚

    2006-01-01

    目的探讨眼挫伤后视网膜脑源性神经营养因子(BDNF)及其受体-酪氨酸蛋白激酶受体B(TrkB)的表达.方法重击法致2个月龄SD雄性大鼠眼挫伤,伤后1、4、7、14 d分别取材,冰冻切片,免疫组化检测BDNF和TrkB,并与正常同龄大鼠视网膜BDNF和TrkB相比较.结果正常同龄大鼠视网膜有少量BDNF和TrkB表达;而挫伤眼,在伤后不同的时间有不同程度的BDNF和TrkB表达增加.结论眼挫伤后视网膜BDNF和TrkB表达增加,说明BDNF和TrkB参与眼挫伤后视网膜的修复过程.

  12. 大鼠脊髓挫伤后BDNF表达的实验性研究%An experimental study on time-dependent expressions of BDNF and BDNF mRNA after spinal cord contusion in rats

    Institute of Scientific and Technical Information of China (English)

    刘杨; 刘季; 王亚方; 任广睦; 王英元

    2007-01-01

    目的 探讨大鼠脊髓挫伤后脑源性神经营养因子(BDNF)在脊髓内的表达变化规律.方法 建立大鼠脊髓挫伤模型,以正常脊髓组织为对照,采用RT-PCR和免疫组化SABC法对伤后即刻、1h、3h、6h、12h、1d、3d、5d、7d大鼠脊髓组织中的BDNF和BDNF mRNA进行检测,并对所得数据进行统计学分析.结果 正常大鼠脊髓组织细胞内有低水平的BDNF mRNA表达和少量BDNF阳性染色细胞,BDNF mRNA和BDNF的积分光密度(IOD)值分别为45.83±3.545、20286.225±2094.955,BDNF阳性细胞数为16.50±3.391;伤后6~12h,BDNF mRNA和BDNF呈升高趋势,5d达高峰,二者的IOD值及阳性细胞数分别为795.83±112.55、54272.143±2704.239和158.17±12.287.伤后7d,BDNF mRNA和BDNF的IOD值及阳性细胞数分别为655.17±80.871、42249.928±809.391和100.17±5.529.各组之间比较,其差异具有统计学意义(P<0.05).BDNF免疫阳性细胞在损伤早期主要是脊髓神经元和少量星形胶质细胞,后期则以小胶质细胞为主.结论 大鼠脊髓挫伤后,脊髓组织细胞中的BDNF及其mRNA增多,并随伤后时间呈现一定规律性变化.

  13. The application of multifocal electroretinogram to evaluate retinal contusion%多焦视网膜电图在评价视网膜挫伤中的应用

    Institute of Scientific and Technical Information of China (English)

    张国明; 黄丽娜; 罗润来; 辛欣; 曾健; 赵铁英; 王林丽; 欧阳芳

    2004-01-01

    目的探讨视网膜挫伤的多焦视网膜电图(mf-ERG),在视网膜挫伤中的应用价值.方法选择30例(30眼)视网膜挫伤,应用德国罗兰多焦电生理系统RETI scan version 3.15进行mf-ERG检查,对1环、1~3环、4~6环及1~6环的波和P1波的振幅密度和潜伏期与对侧正常眼对照,并对患眼4个象限的N1波以及波的振幅密度和潜伏期进行比较.结果 1环、1~3环、4~6环及1~6环的N1波和P1波的振幅密度与对侧眼差异均有显著性(P<0.05),而潜伏期的差异显著性(P>0.05),患眼4个象限的mf-ERG差异无显著性(P>0.05).结论 mf-ERG能够客观反映视网膜挫伤的视功能损害程度,是评价视网膜挫伤时后极部视网膜功能有效工具.

  14. 针刺对骨骼肌急性钝挫伤模型形态学影响的实验观察%Observation on Experiment of the Morphological Effects of Acupuncture on Acute Blunt Skeletal Muscle Contusion Model

    Institute of Scientific and Technical Information of China (English)

    黄怡然; 张茜; 李文迅; 董摩扬; 李娜; 丁婷婷; 路问天; 严安; 郭长青

    2014-01-01

    目的:观察针灸针斜刺阿是穴对家兔腓肠肌急性钝挫伤修复的形态学影响。方法:采用定量负荷自由落体复制肌肉急性闭合性钝挫伤的方法对模型家兔右后肢腓肠肌进行造模,分别于造模后即刻、造模后24 h、造模后48 h测量腓肠肌肿胀度,肌肉硬度,于造模后48 h取材,并检测血清中肌酸激酶、乳酸脱氢酶含量,并通过HE染色光镜和透射电镜观察家兔腓肠肌形态学改变。结果:造模后48 h各组家兔血清肌酸激酶(CK)含量比较,与正常组相比,模型组、针刺组、CsA模型组、CsA针刺组均显著身高(P<0.05),与模型组相比,CsA模型组显著升高(P<0.05);造模后48 h各组家兔乳酸脱氢酶(LDH)含量,与空白组比较,模型组和CsA模型组显著升高(P<0.05),与模型组相比,针刺组和CsA针刺组显著降低(P<0.05);HE染色光镜下,模型组及各干预组可见不同程度的肌纤维损害;透射电镜下模型组及各干预组可见不同程度的超微结构变化。结论:本实验中的造模方法可以成功复制腓肠肌急性闭合性钝挫伤模型,针灸针斜刺阿是穴可有效地促进腓肠肌急性钝挫伤修复,环孢素干预一定程度降低了针刺的修复作用。%Objective:To observe the morphological effects of acupuncture on Ashi points of rabbits with acute gastrocnemius blunt con -tusion.Methods:Modeling was given on gastrocnemius muscle in rabits'hindquarter by using method of free falling with quantitative load to duplicate acute skeletal muscle injury .The swelling degree and hardness of gastrocnemius ( immediately, 24hours, 48hours after building the model) was measured.Materials were taken 48hours after building the model.The content of CK and LDH in serum were tested.The morphological changes of gastrocnemius under light microscope and electron microscope were observed .Results:48 hours after building the model , the content of CK of model group , acupuncture group , CsA model group and CsA acupuncture group increased significantly compared the nature group (P<0.05);compared with the nature group, differences of the content of LDH of model group and CsA model group increased significantly ( P<0.05 ); compared with the model group , acupuncture group , CsA model group and CsA acupuncture group decreased significantly ( P<0.05 ) .Under light microscope , different kinds of muscle fiber trauma could be found in all groups except the nature group .Under electron microscope , Ultrastructural changes could be seen in all groups except the nature group .Conclusion:The modeling method can successfully copy acute closed skeletal gastrocnemius muscle injury model .Acu-puncture could promote the reparative process of acute blunt muscle effectively , while CsA would partially reduce the repairing effect of acupuncture .

  15. Analysis of visual evoked potential of 60 patients with optic nerve contusion%视神经挫伤60例的视觉诱发电位分析

    Institute of Scientific and Technical Information of China (English)

    杜彩凤; 张志威; 曾丽芳

    2008-01-01

    目的:探讨视觉诱发电位(visual evoked potential,VEP)对视神经挫伤临床诊断的作用.方法:对我科近两年临床诊断为视神经挫伤的患者60例(72眼)进行VEP检查.结果:P-VEP正常30眼;P100波潜伏时延迟22眼;P-VEP无波,F-VEP振幅降低12眼;P-VEP、F-VEP均无波8眼.结论:VEP检查是视神经挫伤的客观检查手段之一.

  16. 眼外伤性视神经挫伤视觉诱发电位的分析%Visual Evoked Potential of Optic Nerve Contusion Following Ocular Trauma

    Institute of Scientific and Technical Information of China (English)

    叶秀群

    2010-01-01

    目的 探讨视觉诱发电位(visual evoked potential,VEP)在眼外伤性视神经挫伤中的诊治应用价值.方法 对80例(80眼)外伤性视神经挫伤患者进行VEP测定,并与自身健侧眼进行对照.结果 80例(80眼)VEP检测正常16眼(20.0%),异常64眼(80.0%)(X2=3.95,P<0.05);VEP异常表现为:VEP波形完全消失10只眼,单纯P100波幅降低40只,P100潜伏期延长30只眼;轻度眼受伤波幅、潜伏期与重度眼受伤比较有显著性差异(t=3.614,t=3.518,P均<0.05);两组伤后检查时间与P100潜伏时间和波幅的改变均无相关性(r=039和r=0.015,P均>0.05).结论 VEP检查能准确客观地反映出伤眼的视功能,是临床诊断治疗的重要依据.

  17. Diagnostic Value of VEP Applied in Patients with Optic Nerve Contusion%视觉诱发电位对视神经挫伤早期诊断的应用价值

    Institute of Scientific and Technical Information of China (English)

    骆亦婷

    2013-01-01

    目的 探讨视觉诱发电位(VEP)对外伤性视神经挫伤的早期诊断的应用价值.方法 对56例经临床诊断为外伤性视神经挫伤的患者行VEP检查.结果 比较视神经挫伤患者受伤眼与自身健眼的VEP结果.受伤眼VEP的P100波的振幅、潜伏期有不同程度的异常.患者视力损伤越严重,P100波的改变越明显.VEP检查能灵敏地反映视神经的损伤程度.结论 VEP能为外伤性视神经挫伤的早期临床诊断、视功能评价提供客观依据.

  18. Diagnosis and treatmeat on acute respiratory distress syndrome after pulmonary contusion%肺挫伤并发急性呼吸窘迫综合征的诊断及治疗

    Institute of Scientific and Technical Information of China (English)

    冉鹏

    2008-01-01

    目的 总结肺挫伤并发急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的临床特点及诊治方法.方法 回顾性分析本科收治的37例肺挫伤并发ARDS患者的临床资料.结果 治愈33例,死亡4例.结论 早期诊断,及时、正确地应用机械通气是成功救治肺挫伤并发ARDS患者的关键.

  19. Using value of typing on brain contusion and laceration by combining clinical manifastation with CT imaging%脑挫裂伤CT与临床分型的应用价值

    Institute of Scientific and Technical Information of China (English)

    张合林; 展如才; 田爱民; 齐再利; 侯宗来; 谢良军

    2008-01-01

    目的 探讨脑挫裂伤分型在临床治疗中的应用价值.方法 对1062例脑挫裂伤患者进行回顾性分析,根据临床表现、CT检查结果及腰穿结果进行临床分型.共分为4型:I型为轻度单纯性脑挫裂伤,Ⅱ型为中度局限性脑挫裂伤,Ⅲ型为重度多处脑挫裂伤,Ⅳ型为特重度广泛脑挫裂伤.对每型的预后进行统计学分析.结果 I-Ⅱ型690例,均治愈,其中,12例伴发脑水肿,7例手术,5例保守治疗,均最后痊愈;Ⅲ型242例,治愈35例,轻残121例,重残36例、植物生存13例、死亡8例;Ⅳ型130例.治愈11例、轻残14例、重残56例、植物生存28例、死亡21例.结论 分型级别越高,预后越差.脑挫裂伤分型对临床评估伤情和预后、指导观察和治疗有重要的应用价值.

  20. The effect of massage on IGF- Ⅰduring the rabbit’s skeletal muscle contusion healing process%按摩对兔骨骼肌顿挫伤修复过程中IGF -Ⅰ的影响

    Institute of Scientific and Technical Information of China (English)

    刘仁建; 唐成林; 邹敏; 郜婕; 陈晓琳; 谢辉

    2013-01-01

    目的:研究新西兰兔股四头肌经重物外力损伤后,在肌组织损伤修复过程中,按摩对IGF -Ⅰ蛋白及mRNA表达的影响及其组织形态学的变化,探讨按摩促进肌肉损伤修复的作用机制。方法健康成年雄性新西兰大白兔32只,体重(2.0±0.5)kg ,随机分为4组,正常对照组(A组,n=4)、按摩前对照组(B组,n=4)、自然恢复组(C 组,n=12)和按摩组(D组,n=12)。A组实验动物不作任何处理,作为正常对照;B、C 、D组实验动物用自制打击器制备兔右后肢股四头肌损伤模型。D 组于造模后第5天开始按摩,C 组不予按摩。C、D 组于伤后7d、14d、及21d各取4只实验动物取股四头肌样本,SYBR Green实时定量RT -PCR法检测IGF-ⅠRNA表达,免疫组化学方法检测IGF-Ⅰ蛋白表达,HE染色观察组织病理变化。结果:在按摩的干预作用下,IGF-Ⅰ蛋白及mRNA表达量在7d左右较自然恢复组偏高(P<0.05),而二者在下降过程中按摩组较自然恢复组下降明显加快,且差异具有显著性(P<0.01)。结论:按摩可促进兔损伤股四头肌的组织形态的恢复,可能通过损伤早期上调IGF-I表达促进骨骼肌组织损伤修复。%Objective :To investigate the effect of massage on quadriceps femoris repair after injury by external force by the histological observation and the expressions of IGF -I in New Zealand rabbits so as to explore the possible molecular mechanisms of massage in repair of muscle injury .Methods Thirty -two New Zealand white rabbits ,weighting (2 .0 ± 0 .5) kg ,were randomly divided into 4 groups :normal control(A)(n=4);the control group before the massage(B)(n=4);self -repairing group (C )(n=12 ,further divided into 7d ,14d and 21d time points) ,and massage group (C) (n=12 ,further divided into 7d ,14d and 21d time points) .In group A ,the rabbits were not treated as normal controls ,in groups B 、C and D ,the rabbit models of quadriceps femoris injury were prepared by self -made beater .In group C ,no massage therapy was given as nature recovery controls ;in group D ,massage therapy was given after 5 days since model built successful as massage group .C and D group after injury in 7 d ,14 d ,and 21 d each take 4 different animals take quadriceps samples ,The SYBR Green real -time quantitative RT -PCR method was employed to detect IGF - Ⅰ RNA expressions . Immunohistochemistry staining were used to detect IGF - Ⅰ protein expressions .HE staining was employed to detect the histomorphological change . Results In the massage intervention effect , IGF - Ⅰ protein and mRNA expression the experimental group is higher than the control group in About 7 days(P<0 .05) ,and In the process of falling ,the experimental group than in the control group decreased significantly accelerated ,and the difference was significant (P< 0 .01 ) .Conclusion The histomorphology recovery can be significantly improved after massage ,which may help to repair muscle injury by up -regulation of IGF - Ⅰexpressions in early stage .

  1. Femoral Nailing-related Coagulopathy Determined by First-hit Magnitude: An Animal Study

    OpenAIRE

    2008-01-01

    We asked whether coagulopathy worsened during femoral intramedullary nailing in the presence of lung contusion and hemorrhagic shock and whether reamed or unreamed nailing influenced these results. In 30 Merino sheep, we induced hemorrhagic shock and/or standardized lung contusion followed by femoral nailing. Six groups of five each were assigned as follows: thoracotomy control groups treated with reamed or unreamed nailing, lung contusion groups treated with reamed or unreamed nailing, and s...

  2. 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...the Barell matrix.18 Injury type was classified as fracture, dislocation, sprains/strains, internal, contusion /superficial, open wounds, amputation...analysis because autopsy information was not available for coding. The median ISS was 1 (range: 1–33). Overall, 48% of personnel sustained a contusion

  3. Контузія легень у постраждалих із політравмою

    OpenAIRE

    Тrutyak, І.R.

    2014-01-01

    Objective. To pay attention to the timely diagnosis and adequate treatment of lung contusion in polytrauma patients.Materials and Methods. 208 (52.6 %) out of 392 polytrauma patients had chest trauma. 68.9 % patients were younger than 39 years old. Lung contusion were in 86 (41.3 %). External respiration we estimate for respiratory rate, costosternal condition, percussion, auscultation data and blood oxygen saturation index.Results and Discussion. Pulmonary contusion is characterized by hemor...

  4. Predictors of Acute Lung Injury

    Science.gov (United States)

    2013-02-26

    subjects who developed ARDS on Day 1 tended to be higher than the ISS for the other subjects. Sixteen of the 26 patients had pulmonary contusions noted on...of pulmonary contusions (13), and the cytokine IL-8 in BAL after multiple trauma (2). Navarrete- Navarro et al. (22) studied 693 severe trauma...weeks later. Pulmonary contusions occurring with trauma have been reported to be a significant risk factor for the development of ALI. Becher et al. (13

  5. Clinical Phase IIB Trial of Oxycyte Perflurocarbon in Severe Human Traumatic Brain Injury

    Science.gov (United States)

    2013-10-01

    following traumatic brain and spinal cord injury. Any agent which might exacerbate thrombocytopenia in intracranial hemorrhage into traumatic contusions is...injury. Any agent which might exacerbate thrombocytopenia in intracranial hemorrhage into traumatic contusions is dangerous for obvious reasons. The...spleen or lungs , Oxygen Biotherapeutics presented at Military Health System Research Symposium (MHSRS) 2013 Ft. Lauderdale, that radio labeled platelets

  6. 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

  7. 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.

  8. Observation on Therapeutic Effect of Contusion of Thoracic Wall Treated with Acupuncture of Seda tion and Regulating Qi Method at Different Acupoints%镇静调气法针刺不同腧穴治疗胸壁挫伤疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘世平

    2001-01-01

    方法:将120例胸壁挫伤病例分成阳陵泉组与外关组,采用镇静调气刺法治疗进行对照观察.结果:阳陵泉组治愈率优于外关组(P<0.05).辨证分型的比较,阳陵泉组无差异,外关组气滞型优于血瘀型(P<0.01),病程短者优于病程长者(P

  9. 脑挫裂伤患者脑脊液ApoE多态性与周围脑组织水肿的关系%The relationship between cerebrospinal fluids' ApoE polymorphism and brain edema in the contusion and laceration of brain

    Institute of Scientific and Technical Information of China (English)

    吴启华; 钟志光; 刘安民; 朱钦龙; 陈平; 罗坚

    2006-01-01

    目的 探讨脑挫裂伤患者脑脊液载脂蛋白E基因(ApoE)多态性与周围脑组织水肿的关系.方法 用聚合酶链反应-限制性片段多态性(PCR-RFLP)技术检测36例脑挫裂伤患者ApoE基因型频率,根据CT片计算脑水肿指数,统计学分析它们之间的关系.结果 脑水肿指数与ApoE3呈负相关,而与ApoE4呈正相关,两者都具有统计学意义,脑挫裂伤患者脑脊液ApoE3和ApoE4与周围脑组织水肿具有相关性.结论 脑挫裂伤患者脑脊液ApoE多态性可能是影响周围脑组织水肿的因素之一.

  10. 视神经挫伤对大鼠视网膜谷氨酰胺合酶和兴奋性氨基酸转运蛋白-2表达的影响%Optical nerve contusion on expression of glutamine synthetase and G LT-1 in rat retina

    Institute of Scientific and Technical Information of China (English)

    黄正如; 陈海英; 徐明; 陆炯; 叶凯; 管怀进

    2008-01-01

    目的 通过谷氨酰胺合酶(glutamine synthetase,GS)、兴奋性氨基酸转运蛋白-2(GLT-1)表达的改变,研究视神经挫伤后视网膜谷氨酸代谢变化的机制.方法 建立大鼠右眼视神经挫伤模型48只.术后1 d、7 d、14 d以高效液相色谱分析检测大鼠玻璃体谷氨酸浓度;通过免疫组织化学检测大鼠视网膜GS、GLT-1的表达.结果 视神经挫伤后1 d、7 d、14 d,大鼠玻璃体谷氨酸浓度升高.与对侧眼比较差异具有统计学意义(P=0.001 1、P=0.000 0、P=0.0000).视神经挫伤后1 d.GS高表达(P=0.005 4);挫伤后7d,Gs表达与对侧眼比较差异无统计学意义(P=0.137 9);挫伤后14 d,GS低表达(P=0.033 3).视神经挫伤后1 d、7 d,GLT-1的表达与对照组的差异无统计学意义(P=0.198 5、0.653 7);但挫伤后14 d,GLT-1低表达(P=0.040 3).结论 视神经挫伤后玻璃体谷氨酸浓度升高,与视网膜GS、GLT-1的表达降低有关.

  11. Cardiac trauma confirmed by cardiac markers in dogs: two case reports

    National Research Council Canada - National Science Library

    P.P.V.P. Diniz; D.S. Schwartz; R.C. Collicchio-Zuanaze

    2007-01-01

    Two clinical cases of cardiac contusion in dogs were studied Radiographic evaluation showed pneumothorax and alveolar pattern on diaphragmatic pulmonary lobe in one dog, and arrhythmias in both dogs...

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

    Science.gov (United States)

    2016-07-25

    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

  13. The relation between mechanical impact parameters and most frequent bicycle related head injuries

    NARCIS (Netherlands)

    Monea, A.G.; Perre, G. van der; Baeck, K.; Delye, H.H.; Verschueren, P.; Forausebergher, E.; Lierde, C. van; Verpoest, I.; Sloten, J. van der; Goffin, J.; Depreitere, B.

    2014-01-01

    The most frequent head injuries resulting from bicycle accidents include skull fracture acute subdural hematoma (ASDH), cerebral contusions, and diffuse axonal injury (DAI). This review includes epidemiological studies, cadaver experiments, in vivo imaging, image processing techniques, and computer

  14. Severe cardiac trauma or myocardial ischemia? Pitfalls of polytrauma treatment in patients with ST-elevation after blunt chest trauma

    Directory of Open Access Journals (Sweden)

    Orkun Özkurtul

    2015-09-01

    Conclusion: This case outlines the importance of understanding the key mechanism of injury and the importance of communication at each stage of healthcare transfer. A transesophageal echocardiography can help to identify injuries after myocardial contusion.

  15. ECMO support for right main bronchial disruption in multiple trauma patient with brain injury--a case report and literature review.

    Science.gov (United States)

    Zhou, R; Liu, B; Lin, K; Wang, R; Qin, Z; Liao, R; Qiu, Y

    2015-07-01

    Extracorporeal membrane oxygenation (ECMO) may offer life-saving treatment in severe pulmonary contusion or acute respiratory distress syndrome when conventional treatments have failed. However, because of the bleeding risk of systemic anticoagulation, ECMO should be performed only as a last resort in multiple trauma victims. Here, we report ECMO as a bridge for right main bronchus reconstruction and recovery of traumatic wet lung in a 31-year-old male multi-trauma patient with right main bronchial disruption, bilateral pulmonary contusion, cerebral contusion and long bone fracture. The patient was discharged without any obvious complication. ECMO support in a traumatic brain injured patient with severe hypoxemia caused by lung contusion and/or tracheal bronchus disruption is not an absolute contraindication.

  16. African Journal of Neurological Sciences - 2009 Vol. 28 No 1

    African Journals Online (AJOL)

    The most common abnormalities in LOE were cerebral infarct and brain tumor. ..... (38) The release of glutamate causes excitotoxic cell damage with cell ... the severity of the attacks with sustenance of either cerebral contusion or concussion.

  17. Management of Cardiogenic Shock: Focus on Tissue Perfusion

    NARCIS (Netherlands)

    C.A. den Uil; W.K. Lagrand; S.D.A. Valk; P.E. Spronk; M.L. Simoons

    2009-01-01

    Cardiogenic shock (CS) may result from ischemic heart disease, cardiomyopathy, valvular heart disease, inflammation, myocardial contusion, and cardiac surgery. CS is the leading cause of in-hospital death in patients with acute myocardial infarction. Although early revascularization strategies have

  18. Angiogenic microspheres promote neural regeneration and motor function recovery after spinal cord injury in rats

    National Research Council Canada - National Science Library

    Yu, Shukui; Yao, Shenglian; Wen, Yujun; Wang, Ying; Wang, Hao; Xu, Qunyuan

    2016-01-01

    ... (bFGF) encapsulated in angiogenic microspheres. These spheres were delivered to sites of spinal cord contusion injury in rats, and their ability to induce vessel formation, neural regeneration and improve hindlimb motor function was assessed...

  19. Military Airborne Training Injuries and Injury Risk Factors, Fort Bragg North Carolina, June-December 2010

    Science.gov (United States)

    2011-01-01

    the upper body. The most common injury/anatomic locations combinations were closed head injuries/ concussions (n=74), ankle fractures (n=21), ankle...landing zone, high winds 158/1,780= 88.8/1,000 Kragh & Taylor 19968 Concussions , fractures, contusions, sprains, strains, lacerations 1...location combinations were closed head injuries/ concussions (n=74), ankle fractures (n=21), ankle sprains (n=20), low back sprains (n=14), hip contusions

  20. Respiratory Plasticity Following Spinal Injury: Role of Chloride-Dependent Inhibitory Neurotransmission

    Science.gov (United States)

    2014-10-27

    injuries . In the last year, we performed experiments to test the specific hypothesis that cervical spinal contusion injuries (CSC) and repetitive...blot analyses, prepare a manuscript for publication and begin work on Specific Aims 1c, 1d, 2c. 15. SUBJECT TERMS Spinal Injury , Treatment ...functional recovery from chronic cervical spinal injuries . In this project period, we will test the specific hypothesis that cervical spinal contusion

  1. Deep intracerebral (basal ganglia) haematomas in fatal non-missile head injury in man.

    OpenAIRE

    Adams, J H; Doyle, D.; Graham, D I; Lawrence, A E; McLellan, D R

    1986-01-01

    Deep intracerebral (basal ganglia) haematomas were found post mortem in 63 of 635 fatal non-missile head injuries. In patients with a basal ganglia haematoma, contusions were more severe, there was a reduced incidence of a lucid interval, and there was an increased incidence of road traffic accidents, gliding contusions and diffuse axonal injury than in patients without this type of haematoma. Intracranial haematoma is usually thought to be a secondary event, that is a complication of the ori...

  2. Incidence of Primary Blast Injury in US Military Overseas Contingency Operations: A Retrospective Study

    Science.gov (United States)

    2010-06-01

    blast lung injury,27 codes 860.4 (traumatic pneumothorax, closed) and 861.21 ( pulmonary contusion , closed) were searched in the JTTR. The records of...the explosion-injured patients with closed pneumothoraces and/or closed pulmonary contusions were re- viewed. Patients found to have rib fractures...pressure. The JTTR was searched for these codes with no results. No specific codes for blast lung injury/ pulmonary blast injury or intes- tinal blast

  3. Improved Characterization of Combat Injury

    Science.gov (United States)

    2010-05-01

    of the AIS contain codes for unilateral or bilateral pulmonary contusion , a blast injury to the lung usually involves all lobes, is peripheral, and...overpressure/explosive) not further specified (AIS 3)” in the lung section, with descriptors of mild (AIS 3), moderate (unilateral/bilateral with pulmonary ...fourth cervical vertebra (C4) with cord contusion and incomplete cord syndrome 640214.4 640214.5 From 4 to 5 MAIS 4 5 From severe to critical 2

  4. Characteristics and rehabilitation for patients with spinal cord stab injury

    Science.gov (United States)

    Wang, Fangyong; Zhang, Junwei; Tang, Hehu; Li, Xiang; Jiang, Shudong; Lv, Zhen; Liu, Shujia; Chen, Shizheng; Liu, Jiesheng; Hong, Yi

    2015-01-01

    [Purpose] The objective of the study was to compare the incidence, diagnosis, treatment, and prognosis of patients with spinal cord stab injury to those with the more common spinal cord contusion injury. [Subjects] Of patients hospitalized in China Rehabilitation Research Center from 1994 to 2014, 40 of those having a spinal cord stab injury and 50 with spinal cord contusion were selected. [Methods] The data of all patients were analyzed retrospectively. The cases were evaluated by collecting admission and discharge ASIA (American Spinal Injury Association) and ADL (activity of daily living) scores. [Results] After a comprehensive rehabilitation program, ASIA and ADL scores of patients having both spinal cord stab injury and spinal cord contusion significantly increase. However, the increases were noted to be higher in patients having a spinal cord stab injury than those having spinal cord contusion. [Conclusion] Comprehensive rehabilitation is effective both for patients having spinal cord stab injury and those with spinal cord contusion injury. However, the prognosis of patients having spinal cord stab injury is better than that of patients with spinal cord contusion. PMID:26834329

  5. Hemodynamic and respiratory support using venoarterial extracorporeal membrane oxygenation (ECMO) in a polytrauma patient

    OpenAIRE

    Estevão Bassi; Luciano César Pontes de Azevedo; Eduardo Leite Vieira Costa; Alexandre Toledo Maciel; Edzangela Vasconcelos; César Biselli Ferreira; Luiz Marcelo Sá Malbouisson; Marcelo Park

    2011-01-01

    Existem poucos relatos na literatura sobre o uso de oxigenação extracorpórea por membrana venoarterial por dupla disfunção decorrente de contusão cardíaca e pulmonar no paciente politraumatizado. Relatamos o caso de um paciente de 48 anos, vítima de acidente de motocicleta e automóvel, que evoluiu rapidamente com choque refratário com baixo débito cardíaco por contusão miocárdica e hipoxemia refratária decorrente de contusão pulmonar, tórax instável e pneumotórax bilateral. O suporte extracor...

  6. Clinical features of diffuse axonal injury

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To analyze the mechanism of diffuse axonal injury (DAI) and study the relationship between DAI and brain concussion, brain contusion, and primary brain stem injury.Methods: The clinical data and iconographic characteristics of 56 patients with DAI were analyzed retrospectively.Results: Traffic accidents were the main cause of DAI. Among the 56 cases, 34 were injured for at least twice, and 71.43% of the patients were complicated with contusion.Conclusions: It is considered that DAI is a common pattern of primary brain injury, which is often underestimated. And DAI includes cerebral concussion and primary brain injury, and is often complicated by cerebral cortex contusion. Therefore, it is very simple and practical to divide primary brain injuries into local and diffuse injuries.

  7. Uso de suporte hemodinâmico e respiratório por meio de oxigenação extracorpórea por membrana (ECMO venoarterial em um paciente politraumatizado Hemodynamic and respiratory support using venoarterial extracorporeal membrane oxygenation (ECMO in a polytrauma patient

    Directory of Open Access Journals (Sweden)

    Estevão Bassi

    2011-09-01

    Full Text Available Existem poucos relatos na literatura sobre o uso de oxigenação extracorpórea por membrana venoarterial por dupla disfunção decorrente de contusão cardíaca e pulmonar no paciente politraumatizado. Relatamos o caso de um paciente de 48 anos, vítima de acidente de motocicleta e automóvel, que evoluiu rapidamente com choque refratário com baixo débito cardíaco por contusão miocárdica e hipoxemia refratária decorrente de contusão pulmonar, tórax instável e pneumotórax bilateral. O suporte extracorpóreo foi uma medida efetiva de resgate para esse caso dramático, e o seu uso pôde ser interrompido com sucesso no 4º dia após o trauma. O paciente evoluiu com extenso infarto cerebral, morrendo no 7º dia de internaçãoThere are few reports in the literature regarding the use of venoarterial extracorporeal membrane oxygenation (ECMO for double-dysfunction from both heart and lung contusions in polytrauma patients. This article reports a 48-year-old patient admitted after a traffic accident. He rapidly progressed to shock with low cardiac output due to myocardial contusion and refractory hypoxemia due to pulmonary contusion, an unstable chest wall and bilateral pneumothorax. ECMO was an effective rescue procedure in this dramatic situation and was successfully discontinued on the fourth day after the trauma. The patient also developed an extensive brain infarction and eventually died on the seventh day after admission

  8. Blast-Induced Moderate Neurotrauma (BINT) Elicits Early Complement Activation and Tumor Necrosis Factor Alpha (TNFalpha) Release in a Rat Brain

    Science.gov (United States)

    2012-04-25

    for the damaged tissue. Mol Psychiatry 1997;2:133–6. [20] Chavko M, Prusaczyk WK, McCarron RM. Lung injury and recovery after exposure to blast...complement pathways after contusion -induced spinal cord injury. J Neurotrauma2004;21:1831–46. [23] Bellander BM, von Holst H, Fredman P, Svensson M...Activation of the complement cascade and increase of clusterin in the brain following a cortical contusion in the adult rat. J Neurosurg 1996;85:468–75. [24

  9. Use of Chest Computed Tomography in Stable Patients with Blunt Thoracic Trauma: Clinical and Forensic Perspective

    Directory of Open Access Journals (Sweden)

    Makbule Ergin

    2011-01-01

    fractures were the most common injury. Thorax computed tomography was significantly superior to chest radiography in detecting pneumothorax , hemothorax and lung contusion. Eightyone life threatening lesions were detected and 50 (61%; pneumothorax 13, hemothorax 24, lung contusion 9,and pneumomediastinum 4 of these lesions could not be detected with plain chest radiography. The clinical management [in 15 patients (30%], and the forensic assesment was changed [in 14 (28%] patients were changed.  Conclusion:We concluded that using Computed Tomography of the thorax in thoracic travmas prive meticulous assesment in management of patients and forens icissues.

  10. Traumatic pseudocyst due to blunt trauma: Case report.

    Science.gov (United States)

    Becel, Sinan; Oztok, Beliz; Kurtoglu Celik, Gulhan; Icme, Ferhat; Sener, Alp; Pamukcu Gunaydin, Gul

    2015-09-01

    Damage to lung parenchyma due to blunt thoracic trauma often appears as contusion or hematoma. Cavitary lung lesions or pseudocyst formation due to trauma is a rare phenomenon. In the literature traumatic pseudocysts are also known as pseudocystic hematomas, traumatic lung cavity and traumatic pneumotocel. Traumatic pseudocysts usually have good clinical prognosis, recover spontaneously with supportive treatment and do not require surgery. In this article, we present the case of 52 year old male who was brought to the emergency department after a fall from height and was diagnosed with lung contusions and traumatic cyst.

  11. Penetrating injury of orbital roof and brain sparing the eye ball in a pediatric patient: A rare occurrence.

    Science.gov (United States)

    Kumar, Vikul; Singh, Atul Kumar; Bhaikhel, Kulwant Singh

    2016-01-01

    Blowout fractures are a common occurrence in traumatic brain injury patients. In pediatric age group, orbital floor fracture is a common occurrence. We report a case of 2-year-old male admitted to trauma center, with penetrating injury to the left eye by the clutch of motorbike which fell on the child. Noncontrast computed tomography scan revealed fracture of the roof of left orbit with left frontal contusion sparing the left eyeball. There was also the continuous leak of brain matter from the left eye which suggested tear of dura mater. Urgent left frontal craniotomy was done with the evacuation of contusion, reconstruction of orbital roof, and duroplasty under general anesthesia.

  12. Thoracic Injuries in US Combat Casualties: A 10-Year Review of Operation Enduring Freedom and Iraqi Freedom

    Science.gov (United States)

    2012-01-01

    explosive devices were the most common cause of injury (61.9%). Of 6,030 thoracic injuries identified, pneumothorax and pulmonary contusions were most...1,061 (51.8) Pulmonary contusion 1,028 (50.2) Rib fractures 717 (35) Hemothorax 615 (30) Other chest injury 494 (24.1) Open chest wound 264 (12.9...1890s and was used to treat pulmonary edema in combat ca- sualties during WWI.1 Transfusions with whole blood were also performed in combat hospitals

  13. Development of Medical Adjunctive Treatment for Acute Penetrating Head Injury

    Science.gov (United States)

    1988-04-01

    severity of an injury will increase if certain out- comes are noted. For example, Lung Contusion AIS 3 vs. Lung Contusion with bilat- eral hemothorax ...organisms on the gram stain specimen or culture. Lung abscesses and empyemas are coded under "Pulmonary Complications". 440N. WOUND DEHScENCE. 45N...Patient on Ventilator 0 No I Yes U Unknown 43U. Seizure Type (Choose one ) 0 None 3 Suspected 1 General 4 Type unknown 2 Focal 5 Combination 44U. Number

  14. Computed tomography following paediatric head injury. Computertomographische Verlaufskontrollen nach Schaedel-Hirn-Trauma im Kindesalter

    Energy Technology Data Exchange (ETDEWEB)

    Dietrich, U. (Klinikum Essen (Germany, F.R.). Roentgendiagnostisches Zentralinstitut); Lins, E.; Rembrink, K. (Duesseldorf Univ. (Germany, F.R.). Neurochirurgische Klinik)

    1989-08-01

    38 children with moderate and severe head injuries had CT follow-ups. On initial scans combined lesions dominated over diffuse (diffuse swelling, subarachnoid haemorrhage) and focal lesions (focal swelling, contusions). Contusion showed up until the 6th day after the accident. Two cases of focal lesions could be demonstrated only after intravenous contrast. Up to 40% of the children developed hypodense extracerebral accumulations. Long-term CT follow-ups showed ventricular (84%) and sulcal enlargement (63%) as well as hypodense parenchymal lesions (50%). Combined and diffuse lesions showed a correlation of initial scans and long-term follow-up which could not be demonstrated in case of focal lesions. (orig.).

  15. 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.

  16. CASE REPORT OF COMPOUND COMMINUTED FRACTURE CLAVICLE WITH VEIN AND PLEURAL INJURY

    Directory of Open Access Journals (Sweden)

    Vinayak Nerlikar

    2015-01-01

    Full Text Available We report a case of compound segmental comminuted fracture of the Left clavicle , fracture of second rib , comminuted fracture of scapula with subclavian vein laceration and perforation of the parietal pleura and lung contusion that caused massive haemo - pneumothorax. Emergency exploration followed by repair of subclavian vein , pleura and fixation of clavicle were able to salvage the patient.

  17. Assessment of Cerebral Hemodynamics in Traumatic Brain Injury

    Science.gov (United States)

    2006-11-01

    haemorrhage, and 6 with subarach- noid hemorrhage from ruptured aneurysm . There were 4 cases of cerebral contusions and a single case of traumatic...B. Goldstein, 2003: Significance of Intracranial Pressure Pulse Morphology in Pediatric Traumatic Brain Injury. IEEE, 2491-2494. Anile, C., H. D

  18. External iliac artery injury secondary to indirect pressure wave effect from gunshot wound

    OpenAIRE

    Ng, Eugene; Choong, Andrew MTL

    2016-01-01

    In patients presenting with gunshot wounds, a high clinical suspicion of injury to vasculature and viscera remote from the projectile track is paramount. We present a case of a 17 year old male who sustained a gunshot wound to his abdomen and subsequently developed a right external iliac artery contusion requiring surgery as an indirect effect of the pressure wave from the bullet.

  19. 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 ...

  20. The Effect of rFVIIa on Pro- and Anti-Inflamatory Cytokines in Serum and Cerebrospinal Fluid in a Swine Model of Traumatic Brain Injury

    Science.gov (United States)

    2011-01-01

    cut-down, and a 7.5-French (Fr) pulmonary arterial catheter (Ed- wards Lifesciences, Irvine, CA) was inserted through a 9-Fr sheath introducer in...not significantly different before and 6 h after TBI in control animals. icant bleeding. They found a significant reduction in hemorrhagic contusion

  1. A Randomized Clinical Trial of Allopregnanolone for the Treatment of Severe Traumatic Brain Injury

    Science.gov (United States)

    2010-10-01

    contain infectious agents, such as viruses, that can cause disease. Other issues include the risk of developing circulatory overload and pulmonary ...cell death and cognitive deficits after a contusion of the rat pre-frontal cortex. Neuroscience 123:349-359. He J, Evans CO, Hoffman SW, Oyesiku NM

  2. Progesterone in the Field-Forward Treatment of Traumatic Brain Injury

    Science.gov (United States)

    2009-11-01

    After 10 min, 37 mL of acetone was added and the solution was warmed to ambient temperature. Water (25 mL) was added, and the solvent volume was...created. Concentra- tions were determined by photometric analysis. Cerebral Edema Assay. Surgery. Contusions of the medio - frontal cortex (MFC) were

  3. 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 ...

  4. Ocular Injury Reduction from Ocular Protection Use in Current Combat Operations

    Science.gov (United States)

    2009-04-01

    thickness laceration eyelid 870.2 Laceration eyelid involving lacrimal passage 918 Periocular superficial injury 921 Black eye NOS 921.1 Periocular...unspecified 240408.1 Tear duct laceration 240412.1 Choroidal rupture 240604.1 Corneal contusion 240604.1 Corneal hyphema 240606.1 Corneal laceration 240800.1

  5. Why Is It So Difficult to Gef Information in China?%Why Is It So Difficult to Gef Information in China?

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    You may reel contused and puzzled after living in China for some time as an expat, not only because of its 5000-yearoriental cult-tire and its very complicated language, but also, every day, you'll find it is always so difficult to get full infor- mation here. Why is that?

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Cystic Fibrosis Chest X-Ray Findings: A Teaching Analog

    Science.gov (United States)

    2008-07-01

    methicilin-resistant S. aureus. In newborns , the TORCHES infections predominate: Toxoplasmosis, Rubella, CMV, Herpes, Syphilis, and others. The first...of alveolar filling resulting in increased density on radiographs. The five common “sources” of a consolidation are hemorrhage , exudates...exposure. Table 3: Differential Diagnosis for Air Bronchograms Consolidation Hemorrhage (Blood) Embolism Trauma, contusion Exudate (Pus

  8. Genetic ablation of soluble TNF does not affect lesion size and functional recovery after moderate spinal cord injury in mice

    DEFF Research Database (Denmark)

    Ellman, Ditte Gry; Degn, Matilda; Lund, Minna C.

    2016-01-01

    demonstrated that epidural administration of a dominant-negative inhibitor of solTNF, XPro1595, to the contused spinal cord resulted in changes in Iba1 protein expression in microglia/macrophages, decreased lesion volume, and improved locomotor function. Here, we extend our studies using mice expressing m...

  9. A novel brain trauma model in the mouse : effects of dexamethasone treatment

    NARCIS (Netherlands)

    Hortobágyi, Tibor; Hortobagyi, S; Gorlach, C; Harkany, T; Benbyo, Z; Gorogh, T; Nagel, W; Wahl, M

    2000-01-01

    We describe a novel methodological approach for inducing cold lesion in the mouse as a model of human cortical contusion trauma. To validate its reproducibility and reliability, dexamethasone (Dxm) was repeatedly applied to demonstrate possible antioedematous drug effects. Following tho induction of

  10. In Vivo Measurement of Cervical Spinal Cord Deformation During Traumatic Spinal Cord Injury in a Rodent Model.

    Science.gov (United States)

    Bhatnagar, Tim; Liu, Jie; Yung, Andrew; Cripton, Peter A; Kozlowski, Piotr; Oxland, Thomas

    2016-04-01

    The spinal cord undergoes physical deformation during traumatic spinal cord injury (TSCI), which results in biological damage. This study demonstrates a novel approach, using magnetic resonance imaging and image registration techniques, to quantify the three-dimensional deformation of the cervical spinal cord in an in vivo rat model. Twenty-four male rats were subjected to one of two clinically relevant mechanisms of TSCI (i.e. contusion and dislocation) inside of a MR scanner using a novel apparatus, enabling imaging of the deformed spinal cords. The displacement fields demonstrated qualitative differences between injury mechanisms. Three-dimensional Lagrangian strain fields were calculated, and the results from the contusion injury mechanism were deemed most reliable. Strain field error was assessed using a Monte Carlo approach, which showed that simulated normal strain error experienced a bias, whereas shear strain error did not. In contusion injury, a large region of dorso-ventral compressive strain was observed under the impactor which extended into the ventral region of the spinal cord. High tensile lateral strains under the impactor and compressive lateral strains in the lateral white matter were also observed in contusion. The ability to directly observe and quantify in vivo spinal cord deformation informs our knowledge of the mechanics of TSCI.

  11. Injury Incidence and Injury Risk Factors Among Soldiers in the United States Army Ordnance School

    Science.gov (United States)

    2009-07-01

    tissues, bones or joints.28 Some examples of overuse injuries include shin splints, tendonitis, stress fractures and bursitis .29 In a study...0 other 0 UnknoWn 5.Type of Injury (check one) 0 Normal exam 0 Abrasion/Laceration O.A.rthritis 0 Bursitis D Contusion 0 Dislocation D

  12. Achilles Pain.

    Science.gov (United States)

    Connors, G. Patrick

    Five ailments which can cause pain in the achilles tendon area are: (1) muscular strain, involving the stretching or tearing of muscle or tendon fibers; (2) a contusion, inflammation or infection called tenosynovitis; (3) tendonitis, the inflammation of the tendon; (4) calcaneal bursitis, the inflammation of the bursa between the achilles tendon…

  13. Injury-induced class 3 semaphorin expression in the rat spinal cord

    NARCIS (Netherlands)

    Gispen, W.H.; Winter, F. de; Oudega, M.; Lankhorst, A.J.; Hamers, F.P.; Blits, B.; Ruitenberg, M.J.; Pasterkamp, R.J.; Verhaagen, J.

    2002-01-01

    In this study we evaluate the expression of all members of the class 3 semaphorins and their receptor components following complete transection and contusion lesions of the adult rat spinal cord. Following both types of lesions the expression of all class 3 semaphorins is induced in fibroblast in th

  14. Macrophage Depletion Impairs Skeletal Muscle Regeneration: the Roles of Pro-fibrotic Factors, Inflammation, and Oxidative Stress.

    Science.gov (United States)

    Xiao, Weihua; Liu, Yu; Chen, Peijie

    2016-12-01

    Muscle contusion is one of the most common muscle injuries in sports medicine. Macrophages play complex roles in the regeneration of skeletal muscle. However, the roles of macrophages, especially the mechanisms involved, in the regeneration of muscle contusion are still not fully understood. We hypothesize that the depletion of macrophages impairs skeletal muscle regeneration and that pro-fibrotic factors, inflammation, and oxidative stress may be involved in the process. To test these hypotheses, we constructed a muscle contusion injury and a macrophage depletion model and followed it up with morphological and gene expression analyses. The data showed that fibrotic scars were formed in the muscle of contusion injury, and they deteriorated in the mice of macrophage depletion. Furthermore, the sizes of regenerating myofibers were significantly reduced by macrophage depletion. Pro-fibrotic factors, inflammatory cytokines, chemokines, and oxidative stress-related enzymes increased significantly after muscle injury. Moreover, the expression of these factors was delayed by macrophage depletion. Most of them were still significantly higher in the later stage of regeneration. These results suggest that macrophage depletion impairs skeletal muscle regeneration and that pro-fibrotic factors, inflammation, and oxidative stress may play important roles in the process.

  15. A novel brain trauma model in the mouse : effects of dexamethasone treatment

    NARCIS (Netherlands)

    Hortobágyi, Tibor; Hortobagyi, S; Gorlach, C; Harkany, T; Benbyo, Z; Gorogh, T; Nagel, W; Wahl, M

    2000-01-01

    We describe a novel methodological approach for inducing cold lesion in the mouse as a model of human cortical contusion trauma. To validate its reproducibility and reliability, dexamethasone (Dxm) was repeatedly applied to demonstrate possible antioedematous drug effects. Following tho induction of

  16. 典型脑弥漫性轴索损伤的康复方法与转归l例报告%A case report of rehabilitation method and conversion of one patient with typical diffuse axonal injury

    Institute of Scientific and Technical Information of China (English)

    吴秀书; 承欧梅; 潘春容; 彭国光

    2003-01-01

    @@ DATA OF CASE The patient was male and married, aged 45 years old. He was a en-geneerer, which was hospitalized because hypolegia after traumacaused by traffic accident and memory was bad for half onemonth. The result of skull CT showed diffuse swelling of brainparenchyma and shrink of ventricular system. Fracture and hematomawere not seen (diagnosed as brain contusion).

  17. [Current problems in the reconstructive surgery of the locomotor apparatus in children].

    Science.gov (United States)

    Kupatadze, D D; Nabokov, V V; Malikov, S A; Polozov, R N; Kanina, L Ia; Veselov, A G

    1997-01-01

    The authors analyze results of treatment of 778 children with malignant and benign tumors of the bones, pseudoarthroses, amputations of lower extremities and fingers, injuries of the tendons, vessels and contused-lacerated wounds of distal phalanges of fingers. The possibility to use a precision technique for the reconstructive operations of the vessels in children is shown.

  18. Measuring Intracranial Pressure and Correlation with Severity of Blast Traumatic Brain Injury

    Science.gov (United States)

    2013-01-01

    PLoS One, 2012. 7(4): p. e34504. 22. Ansari, M.A., K.N. Roberts, and S.W. Scheff, A time course of contusion -induced oxidative stress and synaptic...response to pulmonary blast injury. J. Trauma 40, 100S–104S. Cernak, I., Wang, Z., Jiang, J., Bian, X., and Savic, J. (2001). Ultrastructural and

  19. Biochemical indications of cerebral ischaemia and mitochondrial dysfunction in severe brain trauma analysed with regard to type of lesion

    DEFF Research Database (Denmark)

    Nordström, Carl-Henrik; Nielsen, Troels Halfeld; Schalén, Wilhelm

    2016-01-01

    ), cerebral haemorrhagic contusion (CHC) and no mass lesion (NML). Altogether about 150,000 biochemical analyses were performed during the initial 96 h after trauma. Compromised aerobic metabolism occurred during 38 % of the study period. The biochemical pattern indicating mitochondrial dysfunction was more...

  20. The fronto-temporal component in mild and moderately severe head injury

    NARCIS (Netherlands)

    Minderhoud, JM; vanZomeren, AH; vanderNaalt, J

    The history of the identification of the so-called (fronto-)temporal lobe contusion is reviewed. Treatment of minor head injuries actually starts with the right diagnosis. Injuries of the temporal lobe, characterized by a comparatively long period of post-traumatic amnesia should be distinguished

  1. Brain tissue oxygen tension and its response to physiological manipulations: influence of distance from injury site in a swine model of traumatic brain injury.

    Science.gov (United States)

    Hawryluk, Gregory W J; Phan, Nicolas; Ferguson, Adam R; Morabito, Diane; Derugin, Nikita; Stewart, Campbell L; Knudson, M Margaret; Manley, Geoffrey; Rosenthal, Guy

    2016-11-01

    OBJECTIVE The optimal site for placement of tissue oxygen probes following traumatic brain injury (TBI) remains unresolved. The authors used a previously described swine model of focal TBI and studied brain tissue oxygen tension (PbtO2) at the sites of contusion, proximal and distal to contusion, and in the contralateral hemisphere to determine the effect of probe location on PbtO2 and to assess the effects of physiological interventions on PbtO2 at these different sites. METHODS A controlled cortical impact device was used to generate a focal lesion in the right frontal lobe in 12 anesthetized swine. PbtO2 was measured using Licox brain tissue oxygen probes placed at the site of contusion, in pericontusional tissue (proximal probe), in the right parietal region (distal probe), and in the contralateral hemisphere. PbtO2 was measured during normoxia, hyperoxia, hypoventilation, and hyperventilation. RESULTS Physiological interventions led to expected changes, including a large increase in partial pressure of oxygen in arterial blood with hyperoxia, increased intracranial pressure (ICP) with hypoventilation, and decreased ICP with hyperventilation. Importantly, PbtO2 decreased substantially with proximity to the focal injury (contusion and proximal probes), and this difference was maintained at different levels of fraction of inspired oxygen and partial pressure of carbon dioxide in arterial blood. In the distal and contralateral probes, hypoventilation and hyperventilation were associated with expected increased and decreased PbtO2 values, respectively. However, in the contusion and proximal probes, these effects were diminished, consistent with loss of cerebrovascular CO2 reactivity at and near the injury site. Similarly, hyperoxia led to the expected rise in PbtO2 only in the distal and contralateral probes, with little or no effect in the proximal and contusion probes, respectively. CONCLUSIONS PbtO2 measurements are strongly influenced by the distance from the

  2. Bone injuries in the post-traumatic knee: evaluation by magnetic resonance imaging; Comprometimento osseo do joelho pos-trauma: avaliacao pela ressonancia magnetica

    Energy Technology Data Exchange (ETDEWEB)

    De Grossi, Carla Martins [Universidade Federal, Rio de Janeiro, RJ (Brazil). Curso de Pos-graduacao em Radiologia; Marchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Servico de Radiologia; Santos, Alair Augusto S.M.D. dos [Hospital Santa Cruz, Niteroi, RJ (Brazil). Servico de Radiologia]. E-mail: edmarchiori@zipmail.com.br

    2001-06-01

    This paper presents the results of 50 patients with trauma of the knee submitted to magnetic resonance imaging in the period of January 1996 to December 1997. The appearance and incidence of the main bone lesions were evaluated and correlated with the mechanisms of aggression and with clinical data. Associated lesions were also evaluated. Bone contusions were the most commonly findings encountered and were observed in 38 patients (76%). Osteochondral fractures occurred in five patients (10%) and bone fractures were detected in five patients (10%), of which two were associated with contusions in other adjoining bone compartments. Chondromalacia of the patella was observed only in two patients (4%). We concluded that magnetic resonance imaging is the imaging method of choice for the diagnosis of bone lesions in patients with trauma of the knee. (author)

  3. Fracture of a HTR-PMI cranioplastic implant after severe TBI.

    Science.gov (United States)

    López González, Antonio; Pérez Borredá, Pedro; Conde Sardón, Rebeca

    2015-02-01

    A 13-year-old girl with a large left fronto-parietal hard-tissue replacement patient-matched implant (HTR®-PMI) cranioplasty-since she suffered from a traumatic brain injury (TBI) 6 years ago-had a new severe TBI that detached and fractured the implant as well as caused a left subdural hematoma and a large frontal contusion. The hematoma and contusion were removed and the implant was substituted by a provisional titanium mesh. To the best of our knowledge, this is the first case reported about an HTR®-PMI fracture. It is theorized that the bone ingrowth into the macroporous implants, like those of hydroxyapatite, gives strength and resistance to the implant. But in the case we describe, no macroscopic bone ingrowth was detected 6 years after implantation and the traumatic force that impacted over the cranioplasty exceeded its properties.

  4. Penetrating injury of orbital roof and brain sparing the eye ball in a pediatric patient: A rare occurrence

    Directory of Open Access Journals (Sweden)

    Vikul Kumar

    2016-01-01

    Full Text Available Blowout fractures are a common occurrence in traumatic brain injury patients. In pediatric age group, orbital floor fracture is a common occurrence. We report a case of 2-year-old male admitted to trauma center, with penetrating injury to the left eye by the clutch of motorbike which fell on the child. Noncontrast computed tomography scan revealed fracture of the roof of left orbit with left frontal contusion sparing the left eyeball. There was also the continuous leak of brain matter from the left eye which suggested tear of dura mater. Urgent left frontal craniotomy was done with the evacuation of contusion, reconstruction of orbital roof, and duroplasty under general anesthesia.

  5. Injury profiles of road traffic deaths.

    Science.gov (United States)

    Santamariña-Rubio, Elena; Pérez, Katherine; Ricart, Isabel; Arroyo, Amparo; Castellà, Josep; Borrell, Carme

    2007-01-01

    The objective is to describe injuries of road traffic deaths in Barcelona and identify injury profiles by road user type, through a cross-sectional study including road traffic deaths for the period 1997-2004. The data source was the Institut de Medicina Legal de Catalunya. Diagnoses were coded using the International Classification of Diseases, 9th revision, Clinical Modification, and classified using the Barell Matrix. Of the 719 deaths studied, 45% were pedestrians, 32% two wheel motor vehicle users, and 23% car occupants. The injury profile of the road traffic deaths in Barcelona is internal injuries and fractures to the torso and to the head/neck. This profile is repeated in all the road user groups, although pedestrians present higher frequencies of fractures and contusions to extremities and contusions to the head/neck, and fewer internal torso injuries than car occupants or two wheel motor vehicle users.

  6. Causes of condemnation of carcasses from poultry in slaughterhouses located in State of Goiás, Brazil Causas de condenação de carcaças de aves em abatedouros localizados no Estado de Goiás, Brasil

    Directory of Open Access Journals (Sweden)

    Ângela Patrícia Santana

    2008-12-01

    Full Text Available The aim of this research was to detect the principal reasons for condemnation of poultry carcasses in two slaughterhouses (A and B; located in the southeastern region of the State of Goiás, Brazil. The data were collected by the federal veterinary inspection services of the Brazilian Ministry of Agriculture between January and April 2007. The principal causes of condemnation observed in both industries were cellulite, contusion/ fractures and bruises, as well as contamination due to gut severance at evisceration. The three main values observed for each of the causes were different between the slaughter houses. In A, cellulite was the main cause of condemnation with 51.20% of all condemnations, followed by 5.67% for contusion/ fractures and bruising and 33.61% for contamination by evisceration. In B, the major cause of condemnation was 28.90% due to fractures/ contusion and bruising, followed by 25.27% for cellulite and 22.50% for contamination. Other causes of condemnation were observed, however in minute quantities in both industries (O objetivo deste trabalho foi observar as principais causas de condenações de aves, em dois abatedouros frigoríficos (A e B, localizados na região Sudeste do Estado de Goiás, Brasil. Os dados foram obtidos junto ao serviço de inspeção veterinária federal do Ministério da Agricultura, entre o período de janeiro e abril de 2007. As três principais causas de condenações observadas em ambas as indústrias foram celulite, contusão/fratura e hematomas e contaminação devido à ruptura de vísceras no momento da evisceração. Entretanto, os valores observados, para cada uma das causas, foram diferentes entre os frigoríficos A e B. Em A, verificou-se que a celulite foi a maior causa de condenação, com 51,20% do total de condenações, seguido por 5,67% de contusão/fratura e hematomas e 33,61% de contaminação na evisceração. Em B, a maior causa foi 28,90% para fraturas/ contusões e hematomas

  7. X-ray signs of traumas of the cervical region of the spinal cord in the acute period

    Energy Technology Data Exchange (ETDEWEB)

    Brodskaya, Z.L. (Inst. Usovershenstvovaniya Vrachej, Novokuznetsk (USSR))

    The results are analyzed of an X-ray examination of 208 patients with traumas of the cervical region of the spinal column and spinal cord in the acute period of trauma. The authors proposed a scheme that included telespondylography in standard and oblique projections, flebospondylography, discography and pneumomyelography in the Schantz collar with a patient lying on the back. Four types of the spinal cord traumas were diagnosed: compression with osseous elements (76.92%), with sharp discs and strained epidural hematomas (3.85%), isolated contusion of the spinal cord (10.1%) and disorder of the spinal circulation (9.13%). Special emphasis was laid on clinicospondylographic correlations, a critical distance, congenital narrowing of the vertebral canal. The concept of traumatic decompression of the spinal cord was stressed. Symptoms of its contusion and trauma of the spinal circulation were indicated.

  8. Linear undisplaced fracture of temporoparietal bone acting as spontaneous early decompressive craniotomy in a neonate

    Directory of Open Access Journals (Sweden)

    Siddharth Vankipuram

    2015-01-01

    Full Text Available Decompressive craniotomy (DC is used to treat intracranial hypertension associated with traumatic brain injury. Early DC is associated with better outcomes. We present a neonate with a history of fall with computed tomography scan showing a large frontoparietal contusion and associated parietal and temporal bone fracture. This acted as a spontaneous DC causing bony segment to separate due to which the edematous brain could be accommodated. Despite the presence of a large contusion, the child was neurologically intact and medically managed. The neonate presented with a posttraumatic leptomeningeal cyst 2 months later, which had to be repaired surgically. We discuss how a linear undisplaced fracture acts as spontaneous DC and the role of early DC in improving outcomes.

  9. Cerebrovascular Injury Caused by a High Strain Rate Insult in the Thorax

    Science.gov (United States)

    2012-01-17

    al. Severe lung contusion and death after high-velocity behind-armor blunt trauma: relation to protection level. Mil Med 2007; 172 1110-1116 13...of increasing risk developed by Courtney and Courtney9 and the Bowen curves for risk of blast-induced lung injury.2 Figure 1. Experimental conditions...involvement of nitric oxide. Brain Inj 2001; 15 593-612 6. Cooper GJ. Protection of the lung from blast overpressure by thoracic stress wave decouplers. J

  10. Brain Injury Risk from Primary Blast

    Science.gov (United States)

    2012-02-29

    injury has been studied extensively in air-containing organs such as the lungs , gastrointestinal tract, and ear due to their increased...veterans (Owens, 2008). Primary blast injury has been studied extensively in air-containing organs such as the lungs , gastrointestinal tract, and ear... contusions typically on or around the brainstem though there were no skull fractures for any blast intensity. Risk functions were developed that

  11. Physical Mechanisms of Soft Tissue Injury from Penetrating Ballistic Impact

    Science.gov (United States)

    2012-11-30

    2008; 64(6):1420-1426. 18. Gryth D, Rocksen D, Persson JK, Arborelius UP, Drobin D, Bursell J, Olsson LG, Kjellstrom BT. Severe lung contusion and...elastic tissues such as lungs and muscle, where the tissue tends to spring back into place with little damage from temporary stretch, most tissue...in a study comparing penetrating thoracic wounds caused by stab injuries to those caused by gunshot injuries, the occurrence of lung

  12. Aortic arch blunt injury in front-seat passenger.

    Science.gov (United States)

    Türkmen, Nursel; Eren, Bülent; Aydin, Şule Akköse

    2013-10-01

    Aortic arch blunt injury has highly lethal nature. Because the physical examination findings are subtle, immediate medical evaluation is very important. The case was a 72-year-old woman. Massive haemorrhage in the left haemotorax, contusion area in the left lung and a traumatic transection of the distal aortic arch was observed during autopsy. We described intersting autopsy case of aortic arch blunt injury.

  13. Search and Neutralize Factors (Cspgs) that Induce Decline in Transmission to Motoneurons from Spared Fibers after Chronic Spinal Cord Injury

    Science.gov (United States)

    2014-04-01

    clinically relevant treatment to facilitate recovery after SCI. During the 6-moths of no-cost extension we have completed post - mortem immunochemistry... lesions during the recordings. Methods. Spinal cord injury. All procedures were performed on adult, female Sprague-Dawley rats (~210 g) in compliance... post -operative pain. Contusion injury was performed at T10 spinal level using computer controlled IH-0400 Impactor device (Precision System and

  14. Promoting Early Diagnosis of Hemodynamic Instability during Simulated Hemorrhage with the Use of a Real-time Decision-assist Algorithm

    Science.gov (United States)

    2013-01-01

    lower chest wall pain . He was not diaphoretic, and capillary refill was brisk. His clinical ex- amination results was as follows: no apparent head...injury; respiration minimally labored secondary to left-sided chest pain ; Best Motor Response of 5; airway patent, no hoarseness; breathing: trachea...midline, contusion (bruise), left lower rib margin/left upper quadrant body wall, notable splinting on left, equal breath sounds bilaterally; tenderness

  15. Improving Survival and Promoting Respiratory Motor Function after Cervical Spinal Cord Injury

    Science.gov (United States)

    2016-09-01

    increases the demand for health care. However, despite these drastic interventions, the cervical injured patient is still susceptible to death due to...increases the demand for health care. However, despite these drastic interventions, the cervical injured patient is still susceptible to death due to...contusion will promote survival and independence immediately after cervical SCI. 4) Test the hypothesis that respiratory motor patterns and variability

  16. External iliac artery injury secondary to indirect pressure wave effect from gunshot wound

    Institute of Scientific and Technical Information of China (English)

    Eugene Ng; Andrew MTL.Choong

    2016-01-01

    In patients presenting with gunshot wounds,a high clinical suspicion of injury to vasculature and viscera remote from the projectile track is paramount.We present a case of a 17 year old male who sustained a gunshot wound to his abdomen and subsequently developed a right external iliac artery contusion requiring surgery as an indirect effect of the pressure wave from the bullet.

  17. Post-traumatic transient cortical blindness in a child with occipital bone fracture.

    Science.gov (United States)

    Ng, Rachel H C

    2016-12-01

    Cortical blindness as sequelae of trauma has been reported in literature but mostly in the setting of occipital cortex or visual tract damages. We present a case of transient cortical blindness in a child following a closed head injury with a non-displaced occipital bone fracture and underlying occipital lobe contusion. We discuss the pathophysiology behind Post-traumatic transient cortical blindness, relevant investigations, and current management.

  18. Anti-inflammatory activity of Lychnophora passerina, Asteraceae (Brazilian Arnica).

    OpenAIRE

    Oliveira, Patricia Capelari de; Paula, Carmem Aparecida de; Rezende, Simone Aparecida; Campos, Fernanda Torres; Guimarães, Andrea Grabe; Lombardi, Júlio Antônio; Guimarães, Dênia Antunes Saúde

    2011-01-01

    Ethnopharmacological relevance: Lychnophora passerina (Asteraceae), popularly known as arnica, is used to treat inflammation, pain, rheumatism, contusions, bruises and insect bites in Brazilian traditional medicine. Materials and methods: The anti-inflammatory activity of crude ethanolic extract of aerial parts of L. passerina and its ethyl acetate and methanolic fractions had their abilities to modulate the production of NO, TNF-α and IL-10 inflammatory mediators in LPS/IFN-γ-stimulated J774...

  19. Epidemiology of Podiatric Injuries in U.S. Marine Recruits Undergoing Basic Training

    Science.gov (United States)

    1992-01-01

    presenting to the dispensary were screened by a Ingrown toenail 703.00 68 0.29Lower leg strain 844.90 61 0.26 corpsman for referral to the Podiatry Clinic...Fractures 4.7%• [ Cellulitis U Tinea Pedis 5.51/o6 Contusions El Plantar Fasciitis 8.7% 17.7% Tenosynovitis *1 Strains E Ingrown Toenails 0 Blisters

  20. Installation Restoration Program. Phase 2. Confirmation/Quantification. Stage 1. Air Force Plant 4, Fort Worth, Texas. Volume 9. Appendices F-K.

    Science.gov (United States)

    1987-12-01

    Decafluorotriphenyl Phosphine (DFTPP) from Spiked Environmental Samples," American Chemical Society National Meeting. 1986. Shore, F.L.. T.W. Campbell, M.C...are: o Noise o Drilling hazards o Climbing hazards o Heat Stress o Frostbite o Lacerations and Contusions o Snake, Insect and Animal Injuries o Lifting...involves contact with moving machinery and physical objects. The Radian Project Officer should be prepared to deal with cuts and bruises. Snake, Insect and

  1. Drug: D07818 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available C03 Indications: Acute pain due to minor strains, sprains, and contusions. nonsteroidal antiinflammatory drugs (NSAIDs) cyclooxygenas...e-1 (COX-1) inhibitor [HSA:5742] [KO:K00509]; cyclooxygenase...e Target-based classification of drugs [BR:br08310] Enzymes Oxidoreductases cyclooxygenase...c hydroxyethylpyrrolidine cyclooxygenase-2 (COX-2) [HSA:5743] [KO:K11987] Diclofenac [ATC:D11AX18 M01AB05 M0

  2. Evaluation of muscle regeneration in aged animals after treatment with low-level laser therapy

    Directory of Open Access Journals (Sweden)

    Adriana Pertille

    Full Text Available BACKGROUND: The aging process and its associated morphophysiological changes trigger a reduction in the regenerative ability of the satellite cells, a reduction of vascular tissue and an increase in the production of fibroblasts, developing a cellular environment unfavorable for muscle regeneration. OBJECTIVE: The aim of this study was to evaluate the effect of low-level laser therapy on the muscle regeneration of old experimental rat models after contusion. METHOD: A total of 25 old rats,18 months old, were divided into three groups: control group (CT without treatment; injury group (IN with muscle contusion and without treatment and laser group (LA with contusion and low-level laser therapy, 830 nm, 30 mW e 4 J/cm². The no invasive contusion was induced in the Tibialis Anterior muscle and the samples were collected after 7 and 21 treatment sessions. The muscle was evaluated by Light Microscopy and Immunoblotting. RESULTS: After 21 days of treatment there was a significant reduction in the areas of inflammation/regeneration of the LA 21 group compared to IN 21 group. The cross-sectional area of the fibers in regeneration was not statistically different between the groups. Molecular analysis showed that the content of MyoD was statistically reduced in the IN 21 group compared to the CT group. The Myogenin content was increased in the IN 21 group compared to the CT group. Ultimately, the content of TGF-β1 on the IN 21 group was higher when compared to the CT group. CONCLUSION: Considering the parameters used, the laser therapy demonstrated to be effective for muscle regeneration in old rats, however only through its anti-inflammatory effect.

  3. Modeling Pediatric Brain Trauma: Piglet Model of Controlled Cortical Impact.

    Science.gov (United States)

    Pareja, Jennifer C Munoz; Keeley, Kristen; Duhaime, Ann-Christine; Dodge, Carter P

    2016-01-01

    The brain has different responses to traumatic injury as a function of its developmental stage. As a model of injury to the immature brain, the piglet shares numerous similarities in regards to morphology and neurodevelopmental sequence compared to humans. This chapter describes a piglet scaled focal contusion model of traumatic brain injury that accounts for the changes in mass and morphology of the brain as it matures, facilitating the study of age-dependent differences in response to a comparable mechanical trauma.

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

    Science.gov (United States)

    Lacroix, Steve; Hamilton, Laura K; Vaugeois, Alexandre; Beaudoin, Stéfanny; Breault-Dugas, Christian; Pineau, Isabelle; Lévesque, Sébastien A; Grégoire, Catherine-Alexandra; Fernandes, Karl J L

    2014-01-01

    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.

  5. Near-Infrared Spectroscopy to Reduce Prophylactic Fasciotomies for and Missed Cases of Acute Compartment Syndrome in Soldiers Injured in OEF/OIF

    Science.gov (United States)

    2014-10-01

    monitoring to diagnose ACS. The initial experiments using albumin infusion and contusion/ albumin infusions models for inducing ACS were successfully...value. The first five minutes after initiation of monitoring and connection of all leads was selected, unless there was excessive artifact of the...monitoring and connection of all leads was selected, unless there was excessive artifact or the sample was otherwise unrepresentative. Modifications of

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

    OpenAIRE

    Lionberger, David R; Brennan, Michael J.

    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...

  7. Effects of Swimming on Functional Recovery after Incomplete Spinal Cord Injury in Rats

    Science.gov (United States)

    Smith, Rebecca R.; Shum-Siu, Alice; Baltzley, Ryan; Bunger, Michelle; Baldini, Angela; Burke, Darlene A.; Magnuson, David S.K.

    2010-01-01

    One of the most promising rehabilitation strategies for spinal cord injury is weight-supported treadmill training. This strategy seeks to re-train the spinal cord below the level of injury to generate a meaningful pattern of movement. However, the number of step cycles that can be accomplished is limited by the poor weight-bearing capability of the neuromuscular system after injury. We have begun to study swimming as a rehabilitation strategy that allows for high numbers of steps and a high step-cycle frequency in a standard rat model of contusive spinal cord injury. The purpose of the present study was to evaluate the effect of swimming as a rehabilitation strategy in rats with contusion injuries at T9. We used a swimming strategy with or without cutaneous feedback based on original work in the chick by Muir and colleagues. Adult female rats (n = 27) received moderately-severe contusion injuries at T9. Walking and swimming performance were evaluated using the Open-Field Locomotor Scale (BBB; Basso et al., 1995) and a novel swimming assessment, the Louisville Swimming Scale (LSS). Rats that underwent swim-training with or without cutaneous feedback showed a significant improvement in hindlimb function during swimming compared to untrained animals. Rats that underwent swim-training without cutaneous feedback showed less improvement than those trained with cutaneous feedback. Rats in the non-swimming group demonstrated little improvement over the course of the study. All three groups showed the expected improvement in over-ground walking and had similar terminal BBB scores. These findings suggest that animals re-acquire the ability to swim only if trained and that cutaneous feedback improves the re-training process. Further, these data suggest that the normal course of recovery of over-ground walking following moderately-severe contusion injuries at T9 is the result of a re-training process. PMID:16774475

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

    Directory of Open Access Journals (Sweden)

    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.

  9. San Antonio Vasopressin in Shock Symposium Report

    Science.gov (United States)

    2010-01-01

    physiology and clinical strategies. Anesthesiology 2006;105:599–612, quiz 639–40. 7. Russell JA,Walley KR, Singer J, et al. Vasopressin versus...Medicine, Miami, FL, United States e University of British Columbia, Vancouver, BC, Canada f Department of Anesthesiology and Critical Care Medicine...after pulmonary contusion. J Trauma 2005;59:876–82, dis- cussion 882–3. 16. Voelckel WG, Raedler C, Wenzel V, et al. Arginine vasopressin, but not

  10. Traumatic transection of the optic chiasm: Magnetic resonance evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, R.; Goyal, M.; Sharma, A.; Dada, V.K.; Berry, M. [All India Institute of Medical Sciences, New Delhi (India). Departments of Radiodiagnosis and Ophthalmology

    1998-02-01

    Disruption of the optic chiasm is a rare complication of head trauma. Non-contrast Computed tomography of the head showed basi-frontal contusion but no evidence of haematoma. We present the findings on MRI of this entity in a 40-year-old patient presenting with bitemporal hemianopia. Complete chismal transection was confirmed on T1-weighted axial, coronal and sagittal images. Copyright (1998) Blackwell Science Pty Ltd 10 refs., 1 fig.

  11. Enhancing Propriospinal Relays to Improve Functional Recovery after SCI

    Science.gov (United States)

    2016-10-01

    These are the primary neuronal population with surviving axons bypassing the lesion after a moderate contusion injury to the T10 region. This...supraspinal pathways onto the cervical propriospinal neurons . The slight delay in analysis will not delay the overall experimental goals and we are...pilot studies to examine regeneration and sprouting mediated by inhibiting PTEN using our peptides. 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION

  12. Ultrasound-guided musculoskeletal interventions in American football: 18 years of experience.

    Science.gov (United States)

    Dave, Radhika B; Stevens, Kathryn J; Shivaram, Giri M; McAdams, Timothy R; Dillingham, Michael F; Beaulieu, Christopher F

    2014-12-01

    Myotendinous strains, contusions, and hematomas are common injuries in American football. Along with ligament sprains and inflammatory disorders, musculoskeletal injuries often result in lost participation time. This article summarizes 18 years of experience with 128 ultrasound-guided drainages and injections in 69 football players with 88 injuries. When performed by an operator with sufficient expertise in diagnostic and procedural skills, ultrasound-guided musculoskeletal interventions are minimally invasive, are safe, and can play an integral role in injury management.

  13. Traumatic pulmonary pseudocyst.

    Science.gov (United States)

    Gupta, Neeraj; George, Jacob; Gupta, Rakesh C; Dixit, Ramakant

    2013-04-01

    Blunt thoracic trauma manifests in various ways, depending on the structures injured and type of injury. Commonly manifested as parenchymal contusion, at times, pseudacavitation may also been seen on the chest X ray. They are to be differentiated from other causes of pulmonary cavitations which are often done based on history. The so called pulmonary pseudo cysts usually have a benign course and needs only observation.

  14. Traumatic pulmonary pseudocyst

    OpenAIRE

    Gupta, Neeraj; George, Jacob; Gupta, Rakesh C; Dixit, Ramakant

    2013-01-01

    Blunt thoracic trauma manifests in various ways, depending on the structures injured and type of injury. Commonly manifested as parenchymal contusion, at times, pseudacavitation may also been seen on the chest X ray. They are to be differentiated from other causes of pulmonary cavitations which are often done based on history. The so called pulmonary pseudo cysts usually have a benign course and needs only observation.

  15. Lateral Fluid Percussion: Model of Traumatic Brain Injury in Mice

    OpenAIRE

    2011-01-01

    Traumatic brain injury (TBI) research has attained renewed momentum due to the increasing awareness of head injuries, which result in morbidity and mortality. Based on the nature of primary injury following TBI, complex and heterogeneous secondary consequences result, which are followed by regenerative processes 1,2. Primary injury can be induced by a direct contusion to the brain from skull fracture or from shearing and stretching of tissue causing displacement of brain due to movement 3,4. ...

  16. Glyburide - Novel Prophylaxis and Effective Treatment for Traumatic Brain Injury

    Science.gov (United States)

    2014-09-01

    dcTBI (427 kPa), showing the presence of subarachnoid hemorrhage involving the cerebellum and parietal lobe in the path of the blast wave, but...acceleration during the blast. Positioning the head as described above reduced the exposure to blast of the thin parietal and frontal bones, and of the weakest...E) Hematoxylin and eosin (H&E)- stained sections of the parietal cortex in the path of the blast wave, showing an absence of cortical contusions

  17. Indriven sphenoid wing as a cause of post-traumatic epilepsy.

    Science.gov (United States)

    Sumer, M M; Atasoy, H T; Unal, A; Kalayci, M; Mahmutyazicioglu, K; Erdem, O

    2003-11-01

    Post-traumatic epilepsy is more frequent after severe head injuries, however the severity of the trauma is not always correlated with the injured brain tissue. We report a patient whose seizures developed 4 years after a face trauma. Upward displacement of the sphenoid wing caused a contusion at the orbital surface of the frontal lobe. Computed tomography, magnetic resonance imaging and electroencephalographic findings are presented. The patient responded well to commonly used antiepileptic drugs.

  18. Exercise-Dependent Modulation of Neurourological Health Following Spinal Cord Injury

    Science.gov (United States)

    2014-11-01

    complete cervical spinal cord injury in human. Electromyogr Clin Neurophysiol 50, 155 (Apr-Jun, 2010). 4. P. J. Ward et al., Novel multi-system functional...laminectomy of the T9 vertebra , which overlies the T10 por- tion of the spinal cord.21 The Infinite Horizon impactor device (Precision Systems and...Instrumentation, LLC; Fairfax Station, VA) was used to make a 210 kilodyne contusion injury.22 The rostral and caudal sections of vertebrae (T8 and T10) were

  19. Traumatic Brain Injury: Imaging Spectrum from Mild to Severe Closed Head Injury

    Science.gov (United States)

    2008-11-01

    methemoglobin, which corresponds with the area of contusion on CT (Fig. 5C). The constellation of these findings are consistent with diffuse axonal injury...paucity of interoperability of RIS-HIS (Radiology and Hospital Information Systems ) between PACS (Picture Archiving and Communications) and the EHR...falltbi.html. 17 Meagher, R.J., W.F. Young, Subdural hematoma, eMedicine, Nov 2, 2006. http://www.emedicine.com/ NEURO /topic575.htm 18 Ingebrigsten

  20. Early-onset Infectious Complications among Penetrating and Severe Closed Traumatic Brain Injury in Active Duty Deployed during OIF and OEF, 2008-2013

    Science.gov (United States)

    2015-02-01

    trauma that manifests as cerebral contusions and bleeding that occurs inside the skull, but outside the brain. The level of injury severity (mild...the form of early in-theater cranial decompression, followed by aggressive critical care management. 8 Medical advances, in addition to improved body...with severe disability. 4 However, early medical complications, that result from the ongoing cellular effects of trauma from the primary injury

  1. Directing Spinal Cord Plasticity: The Impact of Stretch Therapy on Functional Recovery After SCI

    Science.gov (United States)

    2017-03-01

    that results in locomotor deficits after SCI. We used female SD rats with 25g-cm T10 contusion injuries that were also instrumented with DSI telemetry ...an initial surgery for instrumentation with a telemetry -based 2 lead EMG transmitter (F20-EET, Data Sciences International®, St. Paul, MN;). The...descending supraspinal pathways after spinal cord injury. J Comp Neurol, 2007. 504(3): p. 238-53. 43. Hou, S., H. Duale , and A.G. Rabchevsky, Intraspinal

  2. Acute Compartment Syndrome of the Thigh in Combat Casualties

    Science.gov (United States)

    2013-03-01

    clinical signs and symptoms alone (27, 28). These signs include pain out of proportion, weakness and passive pain on stretch of the muscles in the...spasm/ cramping /weakness). Thirty-three percent (5/15) have pruritis. Twenty-seven percent (4/15) have symptomatic fascial herniations. Twenty...thigh. J. Orthop. Trauma 16:436–438, 2002. 6. Rooser, B., Bengtson, S., Hagglund, G. Acute compartment syndrome from anterior thigh muscle contusion: a

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

    Science.gov (United States)

    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.

  4. 连枷胸救治的进展与争议%Progress and controversy in management of traumatic flail chest

    Institute of Scientific and Technical Information of China (English)

    高劲谋

    2011-01-01

    连枷胸大多合并肺挫伤,综合治疗应包括浮动胸壁的固定和肺挫伤的处理.手术内固定治疗连枷胸越来越多地被接受,但应掌握手术指征和注意手术方法.机械通气应当不是对浮动胸的"气体正压内固定",而是用于因严重肺挫伤导致的急性肺损伤(ALI)和急性呼吸窘迫综合征(ARDS).%Flail chest is mostly associated by pulmonary contusion. Synthetic therapy consists of the fixation of floating chest wall and treatment of pulmonary contusion. Surgical fixation has recently heen suggested as a method to correct floating chest wall. However, the indication and tecchnique of open internal fixation should be stressed. Mechanical ventilation is used to deal with ALI and ARDS due to severe pulmonary contusion instead of 'internal pneumatic stabilizaion with positive pressure "for paradoxical respiration.

  5. The department of Intensive Care Unit, the Chinese medical hospital of Huaian City, Jiangsu province, China%重度肺挫伤临床治疗32例分析

    Institute of Scientific and Technical Information of China (English)

    金晓玲; 周洁

    2012-01-01

    目的 探讨重度肺挫伤的治疗.方法 对32例重度肺挫伤患者采用呼吸机正压通气和使用利尿剂,其中部分重危患者使用血管活性药物稳定循环,观察治疗前后血气分析变化.结果 治疗后PaO2及SaO2均明显升高,差异有显著性(P<0.01).结论 呼吸机正压通气和利尿剂及血管活性药物治疗肺挫伤疗效满意.%Objective To investigate the clinic treatments of serious contusion. Method In 32 patients with contusions, observed the blood gas parameters including PH,PaO2 ,SaO2 ,PaCO2 ,before and after the using positive airway pressure ventilation with diuretic and vascular active drug. Results The values of both PaO2 and SaO2 greatly increased after the ventilation, and the difference was statistically significant P <0. 01 ). Conclusion Utilization of positive airway pressure ventilation with diuretic and vascular active drug contusion has a satisfactory therapeutic effect.

  6. Intramedullary fat globules related to bone trauma: a new MR imaging finding

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Adelaine; Grando, Higor; Fliszar, Evelyne; Pathria, Mini; Resnick, Donald [UCSD Radiology, Musculoskeletal Division, San Diego, CA (United States); Chang, Eric Y. [UCSD Radiology, Musculoskeletal Division, San Diego, CA (United States); VA San Diego Healthcare System, Department of Radiology, San Diego, CA (United States)

    2014-12-15

    The purpose of this study is to describe intraosseous fat globules related to bone trauma that are detectable with magnetic resonance imaging (MRI), to define the relationship of this finding to fracture and bone contusion, to establish the frequency and associated findings. A proposed pathogenesis is presented. We retrospectively reviewed 419 knee MRI examinations in patients with a history of recent injury and MRI findings of fracture or bone contusion. As a control population, 268 knee MRI examinations in patients without MRI findings of recent bone injury were also reviewed. Eight of 419 (1.9 %) patients with acute or subacute knee injury with positive findings of osseous trauma on MRI demonstrated intraosseous fat globules. The mean age of patients with fat globules was greater than that of those without fat globules, and the finding was more commonly seen in women. Fat globules were hyperintense to the normal fatty marrow present elsewhere in the bone on TI-weighted imaging and had a surrounding halo of high signal intensity on fluid-sensitive imaging. Intramedullary fat globules related to bone injury visible on MRI are thought to be due to coalesced fat released by the necrosis of fatty marrow cells. The pathogenesis is supported by histologic studies of fat globules related to osteomyelitis, bone contusions and fractures. As the medullary cavity of long bones in older patients contains more fat than hematopoetic bone marrow, it is likely that this finding is more common with advancing age. (orig.)

  7. Nursing Experience of Severe Brain Trauma Coma Patients%重症脑外伤昏迷患者的护理体会

    Institute of Scientific and Technical Information of China (English)

    薛明琴

    2014-01-01

    Objective To explore ef icient nursing methods for coma patients with severe brain contusion. Methods 32 cases of severe brain contusion patients were selected. During the therapy session, they experienced a series of nursing process, including careful disease observation, ef icient basic nursing, airway management, hyperbaric oxygen therapy and rehabilitation nursing. The nursing ef ects are carefully compared and analyzed. Results Through treatment and nurse care, 12 patients were total y cured and 18 patients turned bet er. The curative rate is 94%. Conclusion The effective nursing procedure is a significant process of preventing complications and reducing the possibilities of disability for severe brain contusion patients.%目的探讨重症脑外伤昏迷患者的合理有效的护理方法。方法对32例重症脑外伤昏迷患者进行严密的病情观察、有效的基础护理、气道管理、高压氧治疗的护理、康复护理。结果经过治疗和护理,治愈12例,好转18例,治愈好转率占94%。结论有效的护理是预防并发症,降低致残率的重要环节。

  8. Trauma induced left maxillary sinus dislocation of eyeball-a case report%外伤致左眼球上颌窦脱位1例报告

    Institute of Scientific and Technical Information of China (English)

    陈瑜; 刘翠萍; 崔莉萍; 李学华; 朱强

    2013-01-01

    Patient male, 27 year old. Left facial and head trauma for 6 hours, due to motor vehicle accident. Patient state of mind was clear at arrival to hospital. Body temperature: 36C; Pulse: 80 Time/Minute; Breath: 20 Time/Minute; Blood pressure: 120/80 mm Hg. An irregular, horizontal laceration at arch of left eyebrow, approximately 8-10 cm. A laceration on left wing of nose skin, approximately 1 cm. A lacetation also under lower eyelid skin of right eye, approximately 2 cm. Left blepharedema and enophthalmos. Orbital and nasal sinuses CT indications;contusion and laceration of the left frontal lobe of brain; fracture of the left orbital frontal, ethmoid, sphenoid bone, left nasal, maxillary sinus and zygoma with soft tissue contusion and laceration; the left eyeball and optic nerve sunk into the maxillary sinus (See figurel). Diagnosis: ①Multiple orbital fractures ;② Left maxillary sinus dislocation of eyeball;③The left frontal lobe contusion and laceration of brain.

  9. Effect of methylprednisolone in medullar injury in rats: a functional and histological analysis

    Directory of Open Access Journals (Sweden)

    Tebet Marcos Antônio

    2003-01-01

    Full Text Available The pharmacological effects of the methylprednisolone in the treatment of the spinal cord lesion, have been researched. An experimental study was performed with twelve wistar rats subjected to a contusion lesion of the spinal cord, by the NYU system. The rats were divided in two groups; the MP group which received the methylprednisolone after the contusion lesion and the control group, which received a 0,9% physiological serum. An analysis of the recuperation of the functional movement of the rats was accomplished on the 2nd, 7th and 14th day after the contusion, utilizing the BBB test. On the fourteenth day the rats were sacrificed and the histological findings of the spinal cord lesion were analyzed. It was noted that the rats from the MP group exhibited an improvement in the recuperation of their functional movement compared to that of the control group, and the histological findings of the spinal cord lesion couldn't be correlated with the recuperation of their functional movement.

  10. Measurement of hemothorax amount in patients with non-penetrating chest trauma by supine chest AP radiograph

    Energy Technology Data Exchange (ETDEWEB)

    Han, Heon; Yang, Joo Hyun; Na, Myung Hoon; Baik, Hee Jong [Chung-Ang Gil Hospital, Incheon (Korea, Republic of)

    1994-10-15

    To evaluate the predictability of amount of hemothorax in the patients with blunt chest trauma, supine chest AP radiographs of 66 patients were reviewed and statistically analyzed. In 66 patients, rib fractures were present in 53 patients, hemothorax in 46 patients, pneumothorax in 25 patients, and pulmonary contusions in 18 patients. Width and length of hemothorax were measured on supine chest AP radiograph, and were correlated with known drained amount of hemothorax. The presence and number of rib fracture, pulmonary contusion, subcutaneous emphysema, fracture of scapula and clavicle, and total opacification of hemithorax were also correlated with the drained amount of hemothorax. In multiple logistic regression analysis, width of hemothorax had the highest correlation with drained amount of hemothorax(regression coeffcient 0.718, p value 0.00005). The presence and number of rib fracture, scapular fracture, subcutaneous emphysema were also correlated with drained amount of hemothorax. But length of hemothorax, pulmonary contusion, clavicular fracture, total opacification of hemithorax were not correlated with drained amount of hemothorax. Measured width of hemothorax in supine chest AP radiograph is the most reliable predictor for estimation of the amount of hemothorax, and may also be used as an indication for the application of closed thoracostomy in the treatment of hemothorax.

  11. Sensory Stimulation Prior to Spinal Cord Injury Induces Post-Injury Dysesthesia in Mice

    Science.gov (United States)

    Hoschouer, Emily L.; Finseth, Taylor; Flinn, Sharon; Basso, D. Michele

    2010-01-01

    Abstract Chronic pain and dysesthesias are debilitating conditions that can arise following spinal cord injury (SCI). Research studies frequently employ rodent models of SCI to better understand the underlying mechanisms and develop better treatments for these phenomena. While evoked withdrawal tests can assess hypersensitivity in these SCI models, there is little consensus over how to evaluate spontaneous sensory abnormalities that are seen in clinical SCI subjects. Overgrooming (OG) and biting after peripheral nerve injury or spinal cord excitotoxic lesions are thought to be one behavioral demonstration of spontaneous neuropathic pain or dysesthesia. However, reports of OG after contusion SCI are largely anecdotal and conditions causing this response are poorly understood. The present study investigated whether repeated application of sensory stimuli to the trunk prior to mid-thoracic contusion SCI would induce OG after SCI in mice. One week prior to SCI or laminectomy, mice were subjected either to nociceptive and mechanical stimulation, mechanical stimulation only, the testing situation without stimulation, or no treatment. They were then examined for 14 days after surgery and the sizes and locations of OG sites were recorded on anatomical maps. Mice subjected to either stimulus paradigm showed increased OG compared with unstimulated or uninjured mice. Histological analysis showed no difference in spinal cord lesion size due to sensory stimulation, or between mice that overgroomed or did not overgroom. The relationship between prior stimulation and contusion injury in mice that display OG indicates a critical interaction that may underlie one facet of spontaneous neuropathic symptoms after SCI. PMID:20121420

  12. Case report of death from falling: Did heart tumor cause syncope?

    Science.gov (United States)

    Yamamoto, Takuma; Takasu, Kosho; Emoto, Yuko; Shikata, Nobuaki; Matoba, Ryoji

    2012-07-01

    A healthy man in his 30s was working on the balustrade of stairs on the second floor. He suddenly fell downstairs without saying anything. On emergency hospitalization, chest echogram showed left hemothorax. Cardiac echogram showed a floating mass from the mitral valve in the left ventricle and severe mitral regurgitation. Surgery for hemothorax and pulmonary contusion was immediately undertaken. However, bleeding from pulmonary contusion could not be controlled and he underwent cardiopulmonary arrest. Autopsy showed a white, elastic, pendulous mass in the left atrium and a white mass in the lower lobe of the left lung. Tumor histology showed a reticular pattern, Schiller-Duval bodies, eosinophilic hyaline globules, and positive staining for α-fetoprotein. We diagnosed primary lung yolk sac tumor with metastatic intracardiac yolk sac tumor, a rare and highly malignant germ cell tumor. It usually arises in the ovaries and testes, and intracardiac yolk sac tumor is rare. Intracavitary tumors induce obstruction of inflow into and outflow from the ventricular cavity. The most common clinical presentation is dyspnea and syncope. In the present case, metastatic cardiac yolk sac tumor might have disturbed cardiac outflow and affected hemodynamics, probably causing syncope. Unfortunately, he was in a high place at that time and fell to receive pulmonary contusion that led to death. Autopsy may sometimes reveal latent diseases which might be related to the cause of death. We should perform autopsy thoroughly to diagnose not only the cause of death but also the factors leading to death.

  13. Gram-Negative Pneumonia Alters Large-Vein Cell-Adhesion Molecule Profile and Potentiates Experimental Stasis Venous Thrombosis.

    Science.gov (United States)

    Obi, Andrea T; Andraska, Elizabeth; Kanthi, Yogendra; Luke, Catherine E; Elfline, Megan; Madathilparambil, Suresh; Siahaan, Teruna J; Jaffer, Farouc A; Wakefield, Thomas W; Raghavendran, Krishnan; Henke, Peter K

    2016-01-01

    Pneumonia is a significant risk factor for the development of venous thrombosis (VT). Cell-adhesion molecules (CAMs) are linked to the pathogenesis of both pneumonia and VT. We hypothesized that remote infection would confer a prothrombogenic milieu via systemic elevation of CAMs. Lung injury was induced in wild-type (C57BL/6) mice by lung contusion or intratracheal inoculation with Klebsiella pneumoniae or saline controls. K. pneumoniae-treated mice and controls additionally underwent inferior vena cava (IVC) ligation to generate VT. Lung-contusion mice demonstrated no increase in E-selectin or P-selectin whereas mice infected with K. pneumoniae demonstrated increased circulating P-selectin, ICAM-1, VCAM-1 and thrombin-antithrombin (TAT) complexes. Mice with pneumonia formed VT 3 times larger than controls, demonstrated significantly more upregulation of vein-wall and systemic CAMs, and formed erythrocyte-rich thrombi. Elevated CAM expression was identified in mice with pneumonia, but not lung contusion, indicating that the type of inflammatory stimulus and the presence of infection drive the vein-wall response. Elevation of CAMs was associated with amplified VT and may represent an alternate mechanism by which to target the prevention of VT. © 2016 S. Karger AG, Basel.

  14. Morbidity following Mexico City's 1985 earthquakes: clinical and epidemiologic findings from hospitals and emergency units.

    Science.gov (United States)

    Sánchez-Carrillo, C I

    1989-01-01

    Medical records of 822 inpatients and outpatients cared for by the Department of the Federal District medical services during the 1985 Mexico City earthquakes were reviewed. Record incompleteness varied between 92.8 percent and 14.0 percent for the various study variables. No gender differences were detected among the groups; more than 70.0 percent of the patients were ages 15 to 64 years. Multiple traumatic injuries were frequent for inpatients across age groups, while simple contusions were more frequent among outpatients. Multiple head traumas, thorax-abdomen multiple traumas, and simple fractures of an arm or leg were more frequently recorded for inpatients than for outpatients. Head wounds with contusions; simple contusion of the thorax-abdomen, arms, and legs; and psychological trauma were more frequently recorded for outpatients. Although a great many records were incomplete, the data may reflect what actually happened to these patients, given the similarity of the findings with other reports of disasters. Improved record keeping during emergencies is needed to standardize the quantity and the reliability of the data so that statistical and medical care requirements are soundly based. The use of standard questionnaires for data collection is stressed to facilitate the management of clinical and epidemiologic activities. Longitudinal studies are needed to determine patterns of physical injuries, psychological trauma, and survival.

  15. Use of diffusion tensor imaging to assess the impact of normobaric hyperoxia within at-risk pericontusional tissue after traumatic brain injury.

    Science.gov (United States)

    Veenith, Tonny V; Carter, Eleanor L; Grossac, Julia; Newcombe, Virginia F; Outtrim, Joanne G; Nallapareddy, Sridhar; Lupson, Victoria; Correia, Marta M; Mada, Marius M; Williams, Guy B; Menon, David K; Coles, Jonathan P

    2014-10-01

    Ischemia and metabolic dysfunction remain important causes of neuronal loss after head injury, and we have shown that normobaric hyperoxia may rescue such metabolic compromise. This study examines the impact of hyperoxia within injured brain using diffusion tensor imaging (DTI). Fourteen patients underwent DTI at baseline and after 1 hour of 80% oxygen. Using the apparent diffusion coefficient (ADC) we assessed the impact of hyperoxia within contusions and a 1 cm border zone of normal appearing pericontusion, and within a rim of perilesional reduced ADC consistent with cytotoxic edema and metabolic compromise. Seven healthy volunteers underwent imaging at 21%, 60%, and 100% oxygen. In volunteers there was no ADC change with hyperoxia, and contusion and pericontusion ADC values were higher than volunteers (P<0.01). There was no ADC change after hyperoxia within contusion, but an increase within pericontusion (P<0.05). We identified a rim of perilesional cytotoxic edema in 13 patients, and hyperoxia resulted in an ADC increase towards normal (P=0.02). We demonstrate that hyperoxia may result in benefit within the perilesional rim of cytotoxic edema. Future studies should address whether a longer period of hyperoxia has a favorable impact on the evolution of tissue injury.

  16. Female Rats Demonstrate Improved Locomotor Recovery and Greater Preservation of White and Gray Matter after Traumatic Spinal Cord Injury Compared to Males.

    Science.gov (United States)

    Datto, Jeffrey P; Bastidas, Johana C; Miller, Nicole L; Shah, Anna K; Arheart, Kristopher L; Marcillo, Alexander E; Dietrich, W Dalton; Pearse, Damien D

    2015-08-01

    The possibility of a gender-related difference in recovery after spinal cord injury (SCI) remains a controversial subject. Current empirical animal research lacks sizable test groups to definitively determine whether significant differences exist. Evaluating locomotor recovery variances between sexes following a precise, clinically relevant spinal cord contusion model can provide valuable insight into a possible gender-related advantage in outcome post-SCI. In the current study, we hypothesized that by employing larger sample sizes in a reproducible contusive SCI paradigm, subtle distinctions in locomotor recovery between sexes, if they exist, would be elucidated through a broad range of behavioral tests. During 13 weeks of functional assessment after a thoracic (T8) contusive SCI in rat, significant differences owing to gender existed for the Basso, Beattie, and Bresnahan score and CatWalk hindlimb swing, support four, and single stance analyses. Significant differences in locomotor performance were noticeable as early as 4 weeks post-SCI. Stereological tissue-volume analysis determined that females, more so than males, also exhibited greater volumes of preserved gray and white matter within the injured cord segment as well as more spared ventral white matter area at the center of the lesion. The stereological tissue analysis differences favoring females directly correlated with the female rats' greater functional improvement observed at endpoint.

  17. Endoscopy-assisted cerebral falx incision via unilateral

    Directory of Open Access Journals (Sweden)

    DONG Ji-rong

    2012-04-01

    Full Text Available 【Abstract】Objective: To investigate the clinical features and treatment strategy of dissymmetric bilateral frontal contusion, and to summarize our experience in treat-ing these patients by minimally invasive surgery. Methods: Over the past 3 years, we have treated a total of 31 patients with dissymmetric bilateral frontal contusion using endoscopy-assisted unilateral cerebral falx incision. Other 30 patients treated by routine bilateral approaches within the same period were taken as control. Results: Seventeen cases (54.8% in the unilateral operation group survived and were in good condition, 8 (25.8% had moderate disability, 4 (12.9% had severe disability, 1 (3.2% was in vegetative state, and 1 (3.2% died. Compared with the control group, the Glasgow Out-come Scale score was not significantly different in the uni-lateral operation group, but the operation time, blood trans-fusion volume, the length of hospital stay, the incidences of mental disorder and olfactory nerve injury were greatly reduced in the unilateral operation group. Conclusions: Endoscopy-assisted unilateral cerebral falx incision can shorten the operation time, reduce surgical trauma and complications in treatment of patients with dis-symmetric bilateral frontal contusion. It can obviously di-minish the chance of delayed intracerebral hematoma and subsequently minimize the incidences of subfalcial and centrencephalic herniation. Key words: Brain injuries; Intracranial hemorrage, traumatic; Endoscopy; Surgically procedures, minimally invasive

  18. The Relationship between Mid-face Fractures and Brain Injuries

    Directory of Open Access Journals (Sweden)

    Khalighi Sigaroudi A.

    2012-03-01

    Full Text Available Statement of Problem: Although advances in technology have led to improvements in man’s life in different aspects, statistics show that the incidence of fractures is increasing in different regions of the body. Recent studies show that midface fractures are strongly associated with patient's death. The exact relationship between different types of facial fractures and brain injuries is still controversial. Purpose: To evaluate individuals with midface fractures from different causes and determine if there is any relationship between various midface fractures and brain injuries. Materials and Methods: In this descriptive cross-sectional retrospective study, we assessed the hospital charts of all the patients with midface fractures at the trauma center of Poursina hospital. The complete medical record of each patient was reviewed. The etiologic and demographic data, the type of midface fracture and brain injury, and Glasgow coma scale (GCS were assessed. The data were analyzed by, the Chi-square, and the Fisher’s exact tests. The statistical package SPSS was used for all the analyses.Results: Of all the patients 47% had brain injury. The Important significant correlations were as follows: Le Fort III with Brain Contusion ( p =0.0001, nasal orbital ethmoid fractures with subdural hematoma ( p =0.0001, frontal fracture with subdural hematoma ( p =0.0001. Zygomatic complex fracture with Brain Contusion ( p =0.009. Nasal fracture correlated with Brain Contusion ( p =0.0001. The zygomatic complex fracture was the most prevalent fracture.Conclusion: Different midface fracture patterns have the risk of brain injury simultaneously. So midface fractures need more attention. According to the results, more attention is needed to be paid to driving rules specially the use of helmet and seat belt.

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

    Directory of Open Access Journals (Sweden)

    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

  20. Cervical intraspinal microstimulation evokes robust forelimb movements before and after injury

    Science.gov (United States)

    Sunshine, Michael D.; Cho, Frances S.; Lockwood, Danielle R.; Fechko, Amber S.; Kasten, Michael R.; Moritz, Chet T.

    2013-06-01

    Objective. Intraspinal microstimulation (ISMS) is a promising method for reanimating paralyzed limbs following neurological injury. ISMS within the cervical and lumbar spinal cord is capable of evoking a variety of highly-functional movements prior to injury, but the ability of ISMS to evoke forelimb movements after cervical spinal cord injury is unknown. Here we examine the forelimb movements and muscles activated by cervical ISMS both before and after contusion injury. Approach. We documented the forelimb muscles activated and movements evoked via systematic stimulation of the rodent cervical spinal cord both before injury and three, six and nine weeks following a moderate C4/C5 lateralized contusion injury. Animals were anesthetized with isoflurane to permit construction of somatotopic maps of evoked movements and quantify evoked muscle synergies between cervical segments C3 and T1. Main results. When ISMS was delivered to the cervical spinal cord, a variety of responses were observed at 68% of locations tested, with a spatial distribution that generally corresponded to the location of motor neuron pools. Stimulus currents required to achieve movement and the number of sites where movements could be evoked were unchanged by spinal cord injury. A transient shift toward extension-dominated movements and restricted muscle synergies were observed at three and six weeks following injury, respectively. By nine weeks after injury, however, ISMS-evoked patterns were similar to spinally-intact animals. Significance. The results demonstrate the potential for cervical ISMS to reanimate hand and arm function following spinal cord injury. Robust forelimb movements can be evoked both before and during the chronic stages of recovery from a clinically relevant and sustained cervical contusion injury.

  1. MR findings in cases of suspected impacted fracture of the femoral neck

    Energy Technology Data Exchange (ETDEWEB)

    Stiris, M.G.; Lilleaas, F.G. [Aker Hospital, Oslo (Norway). Dept. of Diagnostic Radiology

    1997-09-01

    Purpose: To evaluate MR imaging of the hip in patients with a clinically suspected impacted fracture of the femoral neck in cases where conventional plain films show negative or equivocal findings. Material and Methods: Twenty-seven such patients were prospectively examined by MR imaging with a 1.0 T unit, within 24 hours of admittance to hospital. A coronal T1-weighted turbo spin-echo sequence (n=27), and a coronal STIR sequence (n=25) or a coronal T2-weighted turbo spin-echo fast saturation sequence (n=2) were used. The evaluations were made by 2 radiologists with experience in musculoskeletal radiology. Results: There were 6 patients with a petrochanteric fracture, 2 without and 4 with slight displacement. Five patients had an impacted fracture of the femoral neck, and 3 had a fracture of the superior pubic bone. Of 2 patients with advanced arthrosis, i had an impacted femoral neck fracture and the other a nondisplaced intertrochanteric fracture. There was 1 patient who had sustained a nondisplaced acetabular fracture with increased joint fluid and muscle contusions. Three patients had muscle contusions only. Two patients had bone marrow contusions only, while 2 others with advanced coxarthrosis had increased joint fluid only. Three patients showed normal findings. Our findings led to emergency surgery in 13 cases, and conservative measures directed to the specific MR findings in 14 patients. Conclusion: MR imaging should be the first modality of choice in examining patients with a clinically suspected impacted fracture of the femoral neck where conventional films show negative or equivocal findings. (orig.).

  2. Therapeutic strategies targeting caspase inhibition following spinal cord injury in rats.

    Science.gov (United States)

    Ozawa, Hiroshi; Keane, Robert W; Marcillo, Alexander E; Diaz, Paulo H; Dietrich, W Dalton

    2002-09-01

    Apoptosis-modulating therapeutics using active-site mimetic peptide ketones (z-VAD-fluoromethylketone (fmk)) have been reported to be efficacious in delaying the apoptotic response in central nervous system lesions. The purpose of the present study was to examine whether the caspase inhibitor z-VAD fmk prevents apoptosis and improves neurological deficit and tissue damage. One-hundred twenty female Sprague-Dawley rats were randomized into groups that were administered 25 microg of z-VAD-fmk or vehicle 30 min and 24 h after moderate spinal cord contusion (NYU impactor, 12.5 mm at T10). Several routes of administration were tested: (1) via Gelfoam placed on the spinal cord, (2) into the cisterna magna via a subarachnoidal catheter, (3) intravenously via the external jugular vein, or (4) intraperitoneally. Another group was injected with 50 microg of zVAD-fmk or vehicle intraperitoneally 30 min, 24, 48, and 72 h after injury. Animals were evaluated for locomotor function (BBB score) at weekly intervals for 6 weeks after injury and treatment. Spinal cords were then processed for histological analysis to determine whether zVAD-fmk treatment decreased contusion volume. Other spinal cord samples were harvested 24 h after injury and examined for cleavage of XIAP by immunoblot analysis. There were no significant differences in the BBB scores, contusion volumes, and XIAP cleavage between animals receiving the broad specific caspase inhibitor by the various routes and animals receiving vehicle alone. These findings raise critical questions about the use of peptide ketone apoptotic inhibitors in improving functional and histopathological outcomes following spinal cord injury.

  3. Nine year longitudinal retrospective study of Taekwondo injuries

    Science.gov (United States)

    Kazemi, Mohsen; Chudolinski, Artur; Turgeon, Matt; Simon, Aaron; Ho, Eric; Coombe, Lianne

    2009-01-01

    This retrospective longitudinal study aims to describe reported Taekwondo injuries and to examine associations between competitor experience level, age and gender, and the type, location, and mechanism of injury sustained. Additionally, we examined whether recent rule changes concerning increased point value of head shots in adult Taekwondo competition had affected injury incidence. This study was a summation of 9 years of data of competition injury reports, which included 904 injury reports spanning 58 individual competitions. The data was collected on standardized injury reports at time of injury during competition. Care was provided to the athletes, but the type of care provided was not included in the study. Participants included athletes injured during competition who sought care by the health care team, and for whom an injury report was filled out. The data analysis was performed at the Canadian Memorial Chiropractic College. The three most common locations of presenting injury were the head (19%), foot (16%), and thigh (9%). The most common mechanism of presenting injury was found to be a defensive kick (44%), followed by an offensive kick (35%). The most commonly diagnosed injuries were contusions (36%), sprains (19%), and strains (15%). Coloured belts had a higher incidence of contusions, while black belts sustained more joint irritation injuries. Black belts were more likely to suffer multiple injuries. Colored belts suffered more injuries while receiving a kick, while black belts had a larger influence of past history of injury. We found no significant difference in location or type of injury when comparing pre versus post rule change. The most common locations of injury are head, foot, and thigh respectively, and are areas for concern when considering preventative measures. Colour belt competitors are more likely to sustain contusions, which the authors believe is due to more aggressive tactics and lack of control. Those more likely to be injured tend

  4. First Human Implantation of a Bioresorbable Polymer Scaffold for Acute Traumatic Spinal Cord Injury: A Clinical Pilot Study for Safety and Feasibility.

    Science.gov (United States)

    Theodore, Nicholas; Hlubek, Randall; Danielson, Jill; Neff, Kristin; Vaickus, Lou; Ulich, Thomas R; Ropper, Alexander E

    2016-08-01

    A porous bioresorbable polymer scaffold has previously been tested in preclinical animal models of spinal cord contusion injury to promote appositional healing, spare white matter, decrease posttraumatic cysts, and normalize intraparenchymal tissue pressure. This is the first report of its human implantation in a spinal cord injury patient during a pilot study testing the safety and feasibility of this technique (ClinicalTrials.gov Identifier: NCT02138110). A 25-year-old man had a T11-12 fracture dislocation sustained in a motocross accident that resulted in a T11 American Spinal Injury Association Impairment Scale (AIS) grade A traumatic spinal cord injury. He was treated with acute surgical decompression and spinal fixation with fusion, and enrolled in the spinal scaffold study. A 2 × 10 mm bioresorbable scaffold was placed in the spinal cord parenchyma at T12. The scaffold was implanted directly into the traumatic cavity within the spinal cord through a dorsal root entry zone myelotomy at the caudal extent of the contused area. By 3 months, his neurological examination improved to an L1 AIS grade C incomplete injury. At 6-month postoperative follow-up, there were no procedural complications or apparent safety issues related to the scaffold implantation. Although longer-term follow-up and investigation are required, this case demonstrates that a polymer scaffold can be safely implanted into an acutely contused spinal cord. This is the first human surgical implantation, and future outcomes of other patients in this clinical trial will better elucidate the safety and possible efficacy profile of the scaffold. AIS, American Spinal Injury Association Impairment ScaleSCI, spinal cord injurytSCI, traumatic spinal cord injury.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  6. Effect of Coenzyme Q10 on Acute Pulmonary Damage Following the Experimental Thoracic Trauma

    Directory of Open Access Journals (Sweden)

    Murat Koyuncu

    2016-04-01

    Full Text Available Aim: Pulmonary contusion negatively affects prognosis in the case of damages following a trauma. Objective of this experimental study performed in Turkey was to evaluate effects of coenzyme Q10 on primary and secondary damages of pulmonary contusion following experimental thoracic blunt trauma using biochemical and histopathological parameters. Material and Method: A total of 56 Wistar Albino female rats with a mean weight of 205±45 g were included in this study. Rats were randomly divided into seven groups with each group having eight rats. A trauma device which consisted of a fixed platform, and an aluminium tube was prepared. Rats were administered 2.45 J of chest impact energy in order to generate pulmonary contusion. Control and Study groups were named according to the sacrificed time. No process (trauma and/or medication was performed in the sham group, while only trauma was induced in the controls. On the other hand, after induced trauma, intraperitoneal Q10 (0. - 24. - 48. hours was administered to study group. Rats were sacrificed at the end of the after trauma 24, 48 and 72 hours, and their blood and lung tissue samples were analyzed. Results: No significant difference was found between sham and Study-72 groups in terms of high-sensitivity C-reactive protein. On the histopathological examination, no significant difference was found between study and control groups. While no significant difference was found between the sham and study groups, significant difference was observed between sham and control groups. Discussion: Coenzyme Q10, an antioxidant agent, can be used as an antioxidant agent in order to reduce the secondary damage in blunt thoracic trauma.

  7. MR imaging of anterior cruciate ligament tears: is there a gender gap?

    Energy Technology Data Exchange (ETDEWEB)

    Fayad, Laura M. [Morgan Department of Radiology and Radiological Science, John Hopkins Medical Institutions, Baltimore, MD (United States); Parellada, J.Antoni; Parker, Laurence; Schweitzer, Mark E. [Department of Radiology, Thomas Jefferson University Hospital, Gibbon Building Suite 3390, 111 South 11th St., 19107-5098, Philadelphia, PA (United States)

    2003-11-01

    Clinically, females receive anterior cruciate ligament (ACL) tears more commonly than males. We explored whether gender differences exist in MR imaging patterns of ACL tears. At 1.5T, two observers evaluated MR examinations of 84 consecutive age-matched patients (42 males, 42 females, aged 16-39) with ACL tears, for mechanism of injury, extent and type of tear, the presence of secondary signs and associated osseous, meniscal and ligamentous injuries. The most common mechanism of injury for both females and males was the pivot shift mechanism (67 and 60%, respectively). Females were more commonly imaged in the acute stage of tear than males (98 and 67%, respectively, p=0.001) and more commonly possessed the typical posterolateral tibial bone contusion pattern (88 and 62%, respectively, p=0.0131). Males exhibited a deeper femoral notch sign (2.7 and 2.0 mm, p=0.007) and medial meniscal, lateral collateral ligament and posterior cruciate ligament injuries more commonly than females (48 and 24%, p=0.009, 30 and 7%, p=0.035, 17 and 0%, p=0.035). There was no significant difference between genders for the presence of other secondary signs and contusion patterns, associated lateral meniscal tears, presence of O'Donoghue's triad or associated medial collateral ligament injuries. Gender differences in MR imaging patterns of ACL tears exist: females are more commonly imaged in the acute stage and more commonly possess posterolateral tibial bone contusions; males have a more severe presentation than females, associated with more severe lateral femoral condyle and soft tissue injuries. (orig.)

  8. Growth, Nitrogen Vacancy Reduction and Solid Solution Formation in Cubic GaN Thin Films and the Subsequent Fabrication of Superlattice Structures Using AIN and InN

    Science.gov (United States)

    1992-02-01

    n majmiy of t studies have Ween conduted on pu. gallium nitrid thin films having the wutzite scur, and this emphasis contu.s to we pnt day. Recent...adherence and thermal contact The s-bsuates underwent an initial low temperature (=701C) outgasing in the load lock followed by slow heating in the...SEM. Several samples became p-type, as confirmed by the I-V and thermal probe measurements. Figure 2 shows the change in the I-V curves obtained from

  9. Síndrome compartimental pós-fratura de platô tibial

    OpenAIRE

    Guilherme Benjamin Brandão Pitta; Thays Fernanda Avelino dos Santos; Fernanda Thaysa Avelino dos Santos; Edelson Moreira da Costa Filho

    2014-01-01

    As fraturas de platô tibial são relativamente raras e representam, aproximadamente, 1,2% de todas as fraturas. A tíbia, por sua localização subcutânea e pobre cobertura muscular, está exposta a sofrer grandes quantidades de traumatismos, que não são somente fraturas, mas também lesões por achatamento, contusões severas, entre outras que, em um determinado momento, podem causar no enfermo a síndrome compartimental. É relatad...

  10. Physical and chemical injury as causes of sudden cardiac death: the forensic forum.

    Science.gov (United States)

    Riddick, L

    1994-01-01

    Physical and chemical injuries account for the largest number of sudden, unexpected cardiac deaths in persons between the ages of 1 and 44 years. Blunt-force injuries, lacerations, avulsions, and contusions of the heart and great vessels sustained during motor vehicle crashes constitute the most prevalent type of lethal physical trauma to the cardiovascular system. The second most prevalent type of trauma is from penetrating and perforating wounds inflicted by firearms. The mechanisms of these injuries are discussed, with emphasis placed on those factors contributing to lethality. The three most prevalent chemicals associated with sudden cardiac death-ethyl alcohol, cocaine, and tricylic antidepressants-are briefly mentioned.

  11. Upper Eyelid Retraction After Periorbital Trauma

    OpenAIRE

    2008-01-01

    We report four unusual cases of upper eyelid retraction following periorbital trauma. Four previously healthy patients were evaluated for unilateral upper eyelid retraction following periorbital trauma. A 31-year-old man (Case 1) and a 24-year-old man (Case 2) presented with left upper eyelid retraction which developed after blow-out fractures, a 44-year-old woman (Case 3) presented with left upper eyelid retraction secondary to a periorbital contusion that occurred one week prior, and a 56-y...

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

    OpenAIRE

    Yu, Chen Guang; Singh, Ranjana; Crowdus, Carolyn; Raza, Kashif; Kincer, Jeanie; Geddes, James W.

    2013-01-01

    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 four weeks prior to moderate contusive SCI (50 kdyn force) as compared to mice on the same diet without...

  13. ROLE OF MRI IN EVALUATION OF TRAUMATIC KNEE INJURIE S

    Directory of Open Access Journals (Sweden)

    Saurabh

    2013-02-01

    Full Text Available ABSTRACT : MRI is an accurate, noninvasive imaging modality for evaluation of knee injuries, and determines the patient management, saving them f rom unnecessary arthroscopy. Our study focuses on the fundamental biomechanical forces und erlying the most common injuries and correlate MRI findings with specific traumatic mecha nisms. We conducted a retrospective study on 138 patients having prior history of knee trauma. The studies evaluated cruciate ligament tears, collateral ligament injuries, chondromalacia patella, bone marrow contusions, joint effusions, tendon tear, meniscal tear and osteoarth ritis.

  14. 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...... in hospital. Cox regression analyses for proportional hazards confirmed that there was a significantly greater risk of suicide among patients with cerebral contusions or traumatic intracranial haemorrhages than among patients with concussion or cranial fractures (hazard ratios=1.42 and 1.50 respectively...

  15. Arterial injures in open fractures of the leg; Uszkodzenia ukladu tetniczego w otwartych zlamaniach goleni

    Energy Technology Data Exchange (ETDEWEB)

    Konarski, K. [Szpital im. J. Jonstona, Lublin (Poland)

    1993-12-31

    Patterns of arterial injures in open fractures of the leg are presented. It was noted, that union disorders and infection result from changes in both primarily pathological and only recently injured (compression or contusion) arteries. In 23 cases of 3 and 4 degree open fracture femoral arteriography has been performed. In 19 cases (84%) vascular injuries were detected. Most of the arteriographies carried out immediately after injury revealed compression and transposition of the leg arteries. Those cases are prone to develop subsequent arterial occlusion. (author). 19 refs, 6 figs.

  16. Chest injuries in civilian practice (A study of 166 cases

    Directory of Open Access Journals (Sweden)

    Mandke N

    1979-01-01

    Full Text Available Chest injuries constitute a large number of patients admitted in our Intensive Trauma Care Unit. The maximum incidence is in the age group of 20-40 years. Contusions, fracture ribs, pneumo-haemothorax constitute major thoracic injuries. Visceral injuries were always kept in mind while treating these patients with critical condition. Most of the patients could be treated with only active conservativemanagement with proper use of respirators in selected patients. Surgical intervention was required in the patients mostly with visceral injuries. The mortality rate in pure chest injuries is very low. The as-sociated head injuries and abdominal injuries increased the overall mortality rate.

  17. Use of intubating laryngeal mask airway in a morbidly obese patient with chest trauma in an emergency setting

    Directory of Open Access Journals (Sweden)

    Tripat Bindra

    2011-01-01

    Full Text Available A morbidly obese male who sustained blunt trauma chest with bilateral pneumothorax was referred to the intensive care unit for management of his condition. Problems encountered in managing the patient were gradually increasing hypoxemia (chest trauma with multiple rib fractures with lung contusions and difficult mask ventilation and intubation (morbid obesity, heavy jaw, short and thick neck. We performed awake endotracheal intubation using an intubating laryngeal mask airway (ILMA size 4 and provided mechanical ventilation to the patient. This report suggests that ILMA can be very useful in the management of difficult airway outside the operating room and can help in preventing adverse events in an emergency setting.

  18. Post traumatic painful shoulder – a delayed clinical feature of upper lobe lung cancer in a 74 year-old male. - case report -

    Directory of Open Access Journals (Sweden)

    Oana-Cristina Arghir

    2014-02-01

    Full Text Available A 74 year old Caucasian man, presents with a 6 week history of right sided chest pain including traumatic related painful right shoulder. Shoulder minor contusion was diagnosed and partial managed by symptomatic treatment associated to rehabilitation. The pain was initially eased with nonsteroidal anti-inflammatory drug (NSAID use and finally changed worsening. He has evidence of moderate COPD on spirometry and has been commenced on inhalers. An invasive primitive adenocarcinoma lung cancer was confirmed by chest CT scan and lymphnode biopsy through mediastinoscopy

  19. Om at blive skudt med hagl. En "Crime Scene Investigation"

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Henriksen, Jens Henrik Sahl; Jensen, Gorm

    2009-01-01

    Rifle contra shotgun shots are considered in relation to an X-mas goose and shooting accident. Depending on the size of shots, material and velocity, the effect in the body may vary considerably. Myocardial infarction, secondary to accidental shotgun shot, may be caused by 1) thrombosis secondary...... to intima lesion, 2) stenosis, oedema and haematoma in relation to myocardial lesion; and, in addition, 3) the cumulative energy of many shots may give myocardial contusion with infarction. Pathotechnical and pathophysiological analyses are required to reveal complicated causes and effects and unusual...

  20. Combined scintigraphic and radiographic diagnosis of bone and joint diseases

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong Whee (Catholic Medical Coll., Seoul (Korea, Republic of). Dept. of Radiology and Nuclear Medicine)

    1994-01-01

    This book is intended to emphasize the tremendous value of pinhole scintigraphy in diagnosing nearly the whole spectrum of bone and joint diseases. Pinhole scintigraphy discloses anatomic and pathologic as well as chemical alterations in greater detail, permitting analytical interpretation and raising the sensitivity as well. Infections, nonspecific bone inflammation, rheumatic disorders, metabolic and endocrine bone diseases, trauma, and both primary tumors and metastasis can be effectively and specifically examined. By improving sensitivity, many false negative readings can be avoided in early bone metastasis, synovitis, enthesopathies, bone contusion, etc. (orig.)

  1. [Isolated chest trauma in elderly patients].

    Science.gov (United States)

    Yersin, Bertrand; Carron, Pierre-Nicolas; Pasquier, Mathieu; Zingg, Tobias

    2015-08-12

    In elderly patients, a blunt trauma of the chest is associated with a significant risk of complications and mortality. The number of ribs fractures (≥ 4), the presence of bilateral rib fractures, of a pulmonary contusion, of existent comorbidities or acute extra-thoracic traumatic lesions, and lastly the severity of thoracic pain, are indeed important risk factors of complications and mortality. Their presence may require hospitalization of the patient. When complications do occur, they are represented by alveolar hypoventilation, pulmonary atelectasia and broncho-pulmonary infections. When hospitalization is required, it may allow for the specific treatment of thoracic pain, including locoregional anesthesia techniques.

  2. Odontogenic maxillary sinusitis obscured by midfacial trauma.

    Science.gov (United States)

    Simuntis, Regimantas; Kubilius, Ričardas; Ryškienė, Silvija; Vaitkus, Saulius

    2015-01-01

    We present a case of odontogenic maxillary sinusitis whose sinonasal symptomatology was thought to be the consequence of a previous midfacial trauma. The patient was admitted to the Clinic of Oral and Maxillofacial Surgery after more than 10 years of exacerbations of sinonasal symptoms, which began to plague soon after a facial contusion. We decided to perform CT of paranasal sinuses, and despite the absence dental symptomatology, the dental origin of sinusitis was discovered. The majority of sinonasal symptoms resolved after appropriate dental treatment, and there was no need for nasal or sinus surgery.

  3. Electroacupuncture promotes the proliferation of endogenous neural stem cells and oligodendrocytes in the injured spinal cord of adult rats

    Institute of Scientific and Technical Information of China (English)

    Haiying Wu; Min Hu; Dekai Yuan; Yunhui Wang; Jing Wang; Tao Li; Chuanyun Qian

    2012-01-01

    A contusive model of spinal cord injury at spinal segment T8-9 was established in rats. Huantiao (GB30) and Huatuojiaji (Ex-B05) were punctured with needles, and endogenous neural stem cells were labeled with 5-bromo-2'-deoxyuridine (BrdU) and NG2. Double immunofluorescence staining showed that electroacupuncture markedly increased the numbers of BrdU+/NG2+ cells at spinal cord tissue 15 mm away from the injury center in the rostral and caudal directions. The results suggest that electroacupuncture promotes the proliferation of endogenous neural stem cells and oligodendrocytes in rats with spinal cord injury.

  4. Cardiac trauma confirmed by cardiac markers in dogs: two case reports Trauma cardíaco confirmado por marcadores cardíacos em cães: relato de dois casos

    OpenAIRE

    Diniz, P. P. V. P.; Schwartz,D.S.; R.C. Collicchio-Zuanaze

    2007-01-01

    Two clinical cases of cardiac contusion in dogs were studied Radiographic evaluation showed pneumothorax and alveolar pattern on diaphragmatic pulmonary lobe in one dog, and arrhythmias in both dogs. Cardiac troponin I and CK-MB serum analysis associated with clinical history and eletrocardiographic findings indicated accurately the extension of myocardial injury secondary to trauma.Relatam-se dois casos de miocardite em cães. A avaliação radiográfica mostrou pneumotórax e padrão alveolar no ...

  5. Penetrating injury of orbital roof and brain sparing the eye ball in a pediatric patient: A rare occurrence

    OpenAIRE

    Vikul Kumar; Atul Kumar Singh; Kulwant Singh Bhaikhel

    2016-01-01

    Blowout fractures are a common occurrence in traumatic brain injury patients. In pediatric age group, orbital floor fracture is a common occurrence. We report a case of 2-year-old male admitted to trauma center, with penetrating injury to the left eye by the clutch of motorbike which fell on the child. Noncontrast computed tomography scan revealed fracture of the roof of left orbit with left frontal contusion sparing the left eyeball. There was also the continuous leak of brain matter from th...

  6. Beneficial Effects of Sodium or Ethyl Pyruvate after Traumatic Brain Injury in the Rat

    OpenAIRE

    Moro, Nobuhiro; Sutton, Richard L.

    2010-01-01

    Sodium pyruvate (SP) treatment initiated within 5 min post-injury is neuroprotective in a rat model of unilateral cortical contusion injury (CCI). The current studies examined: (1) effects of delayed SP treatments (1000 mg/kg, i.p., at 1, 12 and 24 h), (2) effects of single (1 h) or multiple (1, 12 and 24 h) ethyl pyruvate treatments (EP; at 20 or 40 mg/kg, i.p.), and (3) mechanisms of action for pyruvate effects after CCI. In Experiment 1, both SP and EP treatment(s) significantly reduced th...

  7. Thigh Injuries in American Football.

    Science.gov (United States)

    Lamplot, Joseph D; Matava, Matthew J

    Quadriceps and hamstring injuries occur frequently in football and are generally treated conservatively. While return to competition following hamstring strains is relatively quick, a high rate of injury recurrence highlights the importance of targeted rehabilitation and conditioning. This review describes the clinical manifestations of thigh-related soft-tissue injuries seen in football players. Two of these-muscle strains and contusions-are relatively common, while a third condition-the Morel-Lavallée lesion-is a rare, yet relevant injury.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  9. Emergency assessment and treatment planning for traumatic dental injuries.

    Science.gov (United States)

    Moule, A; Cohenca, N

    2016-03-01

    Trauma involving the dentoalveolar region is a frequent occurrence which can result in the fracturing and displacement of teeth, crushing and/or fracturing of bone and soft tissue injuries including contusions, abrasions and lacerations. This review describes the assessment of patients with these injuries, not in a didactic sense by repeating excellent already published classifications and treatment options, but by addressing questions that arise during assessment. It covers trauma first aid, examination of the patient, factors that affect treatment planning decisions, and the importance of communicating treatment options and prognosis to traumatized patients.

  10. Pathologic conditions of the ligaments and tendons of the knee.

    Science.gov (United States)

    El-Dieb, Adam; Yu, Joseph S; Huang, Guo-Shu; Farooki, Shella

    2002-09-01

    Excellent spatial resolution and unparalleled contrast resolution have allowed MRI to emerge as the dominant imaging modality for diagnosis of ligament and tendon pathology of the knee joint This article presents several important mechanisms of injury associated with tendon and ligament disruptions. When present, the pattern of bone contusions may reveal the vector of force. When one is aware of the mechanism of injury, it is possible to analyze systematically the structures of the knee and maximize the detection of pathology. Recognition of a knee dislocation pattern is important because the diagnosis may be unsuspected, and the clinician may have to be alerted to the possibility of vascular and neural injury.

  11. How computer tomography affected our management of craniocerebral injuries

    Energy Technology Data Exchange (ETDEWEB)

    Malec, R.; Kroo, M.; Rezac, O.; Cernoch, Z. (Karlova Univ., Hradec Kralove (Czechoslovakia). Lekarska Fakulta)

    1983-01-28

    A group of 300 patients with craniocerebral injuries admitted for treatment after the introduction of CT was compared with an equally large aroup prior to CT. The mortality has not dropped significantly, there have been substantially fewer cases of angiography and exploratory trephination, in contrast to more specific operations, resection of the focus of contusion or intracerebral hematoma evacuations. CT shows the surgeon where to operate, it can visualize multiple foci, show the lesion dynamics, and make after-care easier. The decision-making on therapeutical strategy, however, continues to be based on the clinical picture.

  12. Injuries in orienteering.

    Science.gov (United States)

    Linde, F

    1986-09-01

    In a one-year prospective study of 42 elite orienteers, 73 recent injuries (1.7 per runner per year) were found. Acute injuries totalled 52% and 48% were due to overuse. Ankle sprains made up 37% of acute injuries while the remaining were mainly contusions caused by falls or bumps against branches or rocks. Medial shin pain, Achilles peritendinitis, peroneal tenosynovitis and iliotibial band friction syndrome were the most frequent overuse injuries. All overuse injuries were located in the lower extremity while 18% of acute injuries was located elsewhere. Acute injuries were most frequent in the competitive season while overuse injuries occurred most often during the continuous training period.

  13. Trauma torácico : fisiopatologia e prevalência de lesões intra-torácicas em canídeos e felideos politraumatizados no Hospital Veterinário do Porto : utilidade da troponina cardíaca I no diagnóstico de lesões intra-torácicas

    OpenAIRE

    Nunes, Bruno Filipe Fernandes

    2009-01-01

    Dissertação de Mestrado Integrado em Medicina Veterinária Hoje em dia os traumatismos, qualquer que seja a sua etiologia, continuam a ser uma das principais causas de morte nos animais de companhia. O trauma torácico assume uma grande importância nestas situações, face à gravidade das lesões intra-tóracicas que frequentemente se desenvolvem, nomeadamente lesões no parênquima pulmonar (contusão pulmonar), no espaço pleural (hemopneumotórax), no miocárdio e grandes vasos (miocard...

  14. Detection of gene expression pattern in the early stage after spinal cord injury by gene chip

    Institute of Scientific and Technical Information of China (English)

    刘成龙; 靳安民; 童斌辉

    2003-01-01

    Objective: To study the changes of the gene expression pattern of spinal cord tissues in the early stage after injury by DNA microarray (gene chip). Methods: The contusion model of rat spinal cord was established according to Allen's falling strike method and the gene expression patterns of normal and injured spinal cord tissues were studied by gene chip. Results: The expression of 45 genes was significantly changed in the early stage after spinal cord injury, in which 22 genes up-regulated and 23 genes down-regulated. Conclusions: The expression of some genes changes significantly in the early stage after spinal cord injury, which indicates the complexity of secondary spinal cord injury.

  15. Extracorporeal Life Support in a Severe Blunt Chest Trauma with Cardiac Rupture

    Directory of Open Access Journals (Sweden)

    Launey Yoann

    2013-01-01

    Full Text Available This report presents a case of severe blunt chest trauma secondary to a horse riding accident with resultant free-wall rupture of the left ventricle in association with severe lung contusion. We describe the initial surgical and medical management of the cardiac rupture which was associated with a massive haemoptysis due to severe lung trauma. Extra corporeal membrane oxygenation (ECMO support was initiated and allowed both the acute heart and lung failure to recover. We discuss the successful use and pitfalls of ECMO techniques which are sparsely described in such severe combined cardiac and thoracic trauma.

  16. Archery-related injuries of the hand, forearm, and elbow.

    Science.gov (United States)

    Rayan, G M

    1992-10-01

    The five patients reported herein had various archery-related injuries of the upper extremities. Acute injuries included arrow laceration of a digital nerve and artery, contusion of forearm skin and subcutaneous tissue, and compression neuropathy of digital nerves from the bowstring. Chronic injuries included bilateral medial epicondylitis and median nerve compression at the wrist, de Quervain's tenosynovitis, and median nerve compression at the elbow. Essential measures for archery safety include use of archery protective gear, use of a light-weight bow, conditioning of the forearm flexor muscles, and modifications in drawing the bowstring.

  17. Chest Traumas due to Bicycle accident in Childhood

    Directory of Open Access Journals (Sweden)

    Ufuk Cobanoglu

    2011-09-01

    Full Text Available Aim:Childhood injuries are the leading cause of death in children and result in significant healthcare utilization. Trauma is the second most common cause of mortality in children aged 1-4 years and leading cause of death in children older than 4 years. Thoracic injury is the second most leading cause of death in traumatized children. Multisystemic injury is found in more than 50% of children with thoracic injuries most of which are secondary to blunt traumas. We planned this study to evaluate thorax trauma cases secondary to bicycle driving in childhood and to draw attention to the importance of the regulation of traffic rules, the education of bicycle drivers.Material and Methods:  A retrospective evaluation was performed in 17 pediatric patients admitted to the Department of Thoracic Surgery during 2006-2010 with a diagnosis of chest trauma due to bicycle driving. For every patient, a pediatric trauma score (PTS was calculated. Descriptive statistics were performed for PTS. Results; Eleven (64.70% cases were injured due to the tricycle accidents and six cases 6 (35.29% were injured due to the two-wheeled bicycle accidents. The most frequent thoracic pathologies included pulmonary contusion (41.2% and chest wall contusion (29.41%. Extrathoracic injuries were seen in 35.29%, the extremities (17.64% and abdomino pelvic (11.76% being the most commonly involved. Treatment consisted of symptomatic treatment in 12 patients (70.58%, tube thoracostomy in 2 patients (11.76%, and thoracotomy in 1 patient (5.9%. The morbidity was seen in 3 patients (17.64%. The mortality rate was 5.9% (n:1. The mean PTS of the cases who had additional system injuries were significantly worse than the cases who had isolated chest traumas Conclusions: The pediatric thorax has a greater cartilage content and incomplete ossification of the ribs. Due to the pliability of the pediatric rib cage and mediastinal mobility, significant intrathoracic injury may exist in the

  18. Traumatismos oculares Ocular traumas

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    Gelen Welch Ruiz

    2007-12-01

    Full Text Available Se realizó un estudio descriptivo de tipo retrospectivo longitudinal cuyo universo estuvo constituido por 72 ojos de 72 pacientes con traumatismos oculares mecánicos que fueron hospitalizados en el Hospital Militar Central “Dr. Carlos J. Finlay” desde enero de 1999 hasta enero de 2005. Para el análisis estadístico de la información se utilizó el programa automatizado SPSS versión 11.5 en el cual también se conformó la base de datos y se realizaron los cálculos de acuerdo con el tipo de variable analizada. Se utilizaron medidas de resumen, tendencia central y asociación estadística con un nivel de significación de p A retrospective longitudinal and descriptive study was carried out in 72 eyes from 72 patients with mechanical occular traumas, who had been hospitalized in “Dr. Carlos J. Finlay” Military Hospital from December 1999 to January 2005. For the statistical data analysis, an automated program (SPSS 11.5 version was used to create the database and estimations were made according to the variable types. Summary measures, central tendency measures and statistical association with significance level equal to p < 0.05 were employed. Males prevailed (95.8%, the average age was 30.26 years with a minimum rate of 17 years and maximum rate of 82 years. The most frequent mechanisms of trauma were aggressions (23. 6% and injures from secondary projectiles (13.9%. The anterior segment traumas were more frequent (61, 1% than posterior segment traumas (6.94%. Both segments of the eyeball were affected in 39, 1% of eyes which evinced the worst visual acuity. The most common associated injures were hyphema (54, 2% and vitreous hemorrhage (16.6%. Closed trauma (contusions were more common and most of the eyes had better final visual acuity (45, 2% with vision range of 0.6-1.0 and 26.2% with vision range of 0.59-0.1. On the other hand, eyes affected by open trauma (simple wound, contusion-wound, wound with intraocular foreign body and

  19. MR tomography after head and brain trauma: Comparison with CT, EEG and neurological examination

    Energy Technology Data Exchange (ETDEWEB)

    Dewes, W.; Moskopp, D.; Kurthen, M.; Solymosi, L.; Harder, T.; Kersting, G.

    1989-03-01

    56 patients with head and brain trauma and in coma were studied prospectively by means of MRT, CT, EEG and neurological examination. All patients had initial CT and EEG admission. MRT showed that in our patients morphological return to normal was the exception. Patients with head and brain injuries should be examined by MRT during the course of their illness. The use of special sequences, such as gradient-echo sequences for the diagnosis of haemorrhagic contusions, is indicated. CT should be retained for evaluating bone injury and cerebral damage during the acute stage.

  20. CT findings of the brain damages resulting from the high voltage electric injuries

    Energy Technology Data Exchange (ETDEWEB)

    Kim, So Eun; Kim, Young Keun; Shim, Hyang Yi; Lee, Shin Hyung; Lee, Chang Joon [National Medical Center, Seoul (Korea, Republic of)

    1994-02-15

    The purpose of this study is to evaluate the CT features and pathogenesis of the electric brain injuries. We reviewed the CT scans of 3 patients injured by high-voltage electricity. We evaluated the findings early and delayed periods in each patients. The early CT findings were diffuse brain edema, scalp swelling, and focal hemorrhagic contusion. The findings of delayed period were cerebral infarction, pneumocephalus, brain abscess, and pneumatocele. CT was useful to correlate the pathogenesis and variable features of electric brain injuries.

  1. A novel thermoelectric cooling device using Peltier modules for inducing local hypothermia of the spinal cord: the effect of local electrically controlled cooling for the treatment of spinal cord injuries in conscious rats.

    Science.gov (United States)

    Morizane, Kei; Ogata, Tadanori; Morino, Tadao; Horiuchi, Hideki; Yamaoka, Gotaro; Hino, Masayuki; Miura, Hiromasa

    2012-03-01

    We developed a novel thermoelectric cooling device using Peltier modules for the treatment of spinal cord injury in rats. The extracorporeal electrically cooling component was attached to the aluminum arched plate which was placed on the surface of the spinal cord after the contusion injury in the 11th thoracic spinal cord. During the hypothermic treatment, rats were awake and could move in the cage. Hind limb motor function, evaluated using a BBB scale, in the hypothermic animals (33°C for 48 h) was significantly higher than that in the normothermic animals from 2 weeks to 8 weeks after the injury.

  2. Thermal hyperalgesia assessment for rats after spinal cord injury: developing a valid and useful pain index.

    Science.gov (United States)

    Kim, Hung Tae; Kim, Taehee; Novotny, Brianna; Khan, Nayab; Aksamit, James; Siegel, Steven; Miranpuri, Gurwattan S; Resnick, Daniel K

    2014-06-01

    Ongoing research to understand the mechanism behind pain is heavily dependent on animal testing. However, unlike humans, animal subjects cannot directly communicate with researchers to express the degree of pain they are experiencing. Therefore, measuring the presence of pain in animal studies is based on behavioral tests. The use of arbitrary values for determining the presence of pain in animal studies is an oversimplification of a complex and cortically dependent process. The purpose of the present study was to identify a statistically supported latency time indicator that can be used as an accurate index for hyperalgesia to thermal stimuli in Sprague-Dawley rats subjected to T9 contusive spinal cord injury (SCI). A statistical analysis of latency of withdrawal from stimulus-mediated spinal reflex in 979 Sprague-Dawley rats that had been subjected to a T9 contusive SCI was performed. This is a retrospective review of a large research database derived from a series of studies performed evaluating thermal hyperalgesia in rats after SCI. Sprague-Dawley rats underwent a T9 contusive SCI and were tested for withdrawal latency from a heat stimulus. Assessment was done preinjury and on Postinjury Days 21, 28, 35, and 42 of the chronic phase of injury via a plantar withdrawal test. The baseline test results of the 979 rats showed a significant resemblance to the normal distribution. The observed change in withdrawal showed mean latency drops of 0.42 second (standard error of the mean [SEM], 0.18; p=.026), 0.57 second (SEM, 0.19; p=.004), 0.63 second (SEM, 0.19; p=.002), and 0.69 second (SEM, 0.19; p=.0003). The standard deviation from the mean at all four postsurgical assessments was between 2.8 and 2.9 seconds. Interpretation of withdrawal latency times as a marker for thermal hyperalgesia must be based on an appreciation for the normal distribution of pain scores. Recognizing that withdrawal latency is normally distributed both before and after injury allows for

  3. Pulmonary laceration secondary to a traumatic soccer injury: a case report and review of the literature.

    Science.gov (United States)

    Idriz, Sanjin; Abbas, Ausami; Sadigh, Sufi; Padley, Simon

    2013-11-01

    Pulmonary lacerations are an uncommon injury typically associated with high-impact trauma. Most cases occur as a result of high-speed road traffic collisions. Although chest wall and pleural injuries are commonly associated with sports-related thoracic trauma, pulmonary injuries are far less common. There are only a few reported cases of significant pulmonary trauma associated with sports injuries, the majority of which have described pulmonary contusions occurring as a result of thoracic injury sustained while playing high-impact contact sports such as American football. Pulmonary laceration occurring as result of soccer-related thoracic trauma has never previously been reported.

  4. Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients

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    Ali Vafaei

    2016-01-01

    Full Text Available Introduction: Application of chest radiography for all multiple trauma patients is associated with a significant increase in total costs, exposure to radiation, and overcrowding of the emergency department. Ultrasound has been introduced as an alternative diagnostic tool in this regard. The aim of the present study is to compare the diagnostic accuracy of chest ultrasonography and radiography in detection of traumatic intrathoracic injuries. Methods: In the present prospective cross-sectional study, patients with traumatic intrathoracic injuries, who were referred to the emergency department from December 2013 to December 2014, were assessed. The patients underwent bedside ultrasound, radiographic and computed tomography (CT scan examinations based on ATLS recommendations. Screening performance characteristics of ultrasonography and radiography were compared using SPSS 21.0. Chest CT scan was considered as gold standard. Results: 152 chest trauma patients with a mean age of 31.4 ± 13.8 years (range: 4 ‒ 67, were enrolled (77.6% male. Chest CT scan showed pulmonary contusion in 48 (31.6% patients, hemothorax in 29 (19.1%, and pneumothorax in 55 (36.2% cases. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion were 0.91 (95% CI: 0.86‒0.96, 0.86 (95% CI: 0.78‒0.94, and 0.80 (95% CI: 0.736‒0.88, respectively. Area under the ROC curve of radiography was 0.80 (95% CI: 0.736‒0.87 for detection of pneumothorax, 0.77 (95% CI: 0.68‒0.86 for hemothorax, and 0.58 (95% CI: 0.5‒0.67 for pulmonary contusion. Comparison of areas under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax (p = 0.02 and pulmonary contusion (p < 0.001. However, the diagnostic value of the two tests was equal in detection of hemothorax (p = 0.08. Conclusion: The results of the present study showed that ultrasonography is preferable to radiography in the initial

  5. Closed lung trauma.

    Science.gov (United States)

    Feden, Jeffrey P

    2013-04-01

    Pulmonary injuries from blunt thoracic trauma are seen regularly with high-energy mechanisms but described less frequently in association with sports. Pneumothorax, hemothorax, pneumomediastinum, and pulmonary contusion are uncommon with athletic participation and often follow a benign clinical course. Life-threatening complications may arise, and athletes with chest trauma deserve close attention. Appropriate diagnosis is suggested by history and physical examination; conventional chest radiography is preferred as the initial imaging study but has limitations. Use of CT for trauma has improved diagnostic sensitivity for occult injury, although this may not alter management or outcomes. Return to play is guided by resolution of symptoms and radiographic findings.

  6. Role of Akt and mammalian target of rapamycin in functional outcome after concussive brain injury in mice.

    Science.gov (United States)

    Zhu, Xiaoxia; Park, Juyeon; Golinski, Julianne; Qiu, Jianhua; Khuman, Jugta; Lee, Christopher C H; Lo, Eng H; Degterev, Alexei; Whalen, Michael J

    2014-09-01

    Akt (protein kinase B) and mammalian target of rapamycin (mTOR) have been implicated in the pathogenesis of cell death and cognitive outcome after cerebral contusion in mice; however, a role for Akt/mTOR in concussive brain injury has not been well characterized. In a mouse closed head injury (CHI) concussion traumatic brain injury (TBI) model, phosphorylation of Akt (p-Akt), mTOR (p-mTOR), and S6RP (p-S6RP) was increased by 24 hours in cortical and hippocampal brain homogenates (Pconcussion TBI independent of cell death that may contribute to improved outcome by Nec-1.

  7. [Pulmonary mucormycosis in a multiple-trauma patient].

    Science.gov (United States)

    Grandin, W; Dessieux, T; Hounfodji, P; Viquesnel, G; Ouchikhe, A; Gérard, J-L

    2006-05-01

    Mucormycosis are opportunist infections occurring usually among predisposed patients. We report a case of an 18-year-old male with a severe thoracic trauma who developed an Absidia infection on his contused pulmonary parenchyma, without presenting the usual risk factors (diabetes mellitus, immunodeficiency). The early diagnosis using bronchoscopy has probably improved the outcome by allowing a faster treatment. After 18-months, the infectious process resolved thanks to a combination of a medical treatment composed of high-dose amphotericin B lipid formulation, itraconazole and a complementary surgical treatment.

  8. EFEITOS DA CRIO E TERMOTERAPIA CONTRA O DANO OXIDATIVO INDUZIDO POR DISTENSÃO MUSCULAR EM RATOS

    OpenAIRE

    Nélson Rodrigues de Carvalho

    2012-01-01

    Lesões musculares esqueléticas estão entre as causas mais frequentes de comprometimento funcional do tecido muscular, acometendo a qualidade de vida e são as principais responsáveis pela perda do ritmo de treinamento no caso de atletas. As lesões mais frequentes são as contusões e distensões musculares. Assim, o desenvolvimento de terapias que amenizem e possam acelerar o processo de reparo celular e reabilitação tecidual são de grande importância. Desta forma, aplicações terapêuticas de agen...

  9. [Chest trauma].

    Science.gov (United States)

    Freixinet Gilart, Jorge; Ramírez Gil, María Elena; Gallardo Valera, Gregorio; Moreno Casado, Paula

    2011-01-01

    Chest trauma is a frequent problem arising from lesions caused by domestic and occupational activities and especially road traffic accidents. These injuries can be analyzed from distinct points of view, ranging from consideration of the most severe injuries, especially in the context of multiple trauma, to the specific characteristics of blunt and open trauma. In the present article, these injuries are discussed according to the involvement of the various thoracic structures. Rib fractures are the most frequent chest injuries and their diagnosis and treatment is straightforward, although these injuries can be severe if more than three ribs are affected and when there is major associated morbidity. Lung contusion is the most common visceral lesion. These injuries are usually found in severe chest trauma and are often associated with other thoracic and intrathoracic lesions. Treatment is based on general support measures. Pleural complications, such as hemothorax and pneumothorax, are also frequent. Their diagnosis is also straightforward and treatment is based on pleural drainage. This article also analyzes other complex situations, notably airway trauma, which is usually very severe in blunt chest trauma and less severe and even suitable for conservative treatment in iatrogenic injury due to tracheal intubation. Rupture of the diaphragm usually causes a diaphragmatic hernia. Treatment is always surgical. Myocardial contusions should be suspected in anterior chest trauma and in sternal fractures. Treatment is conservative. Other chest injuries, such as those of the great thoracic and esophageal vessels, are less frequent but are especially severe.

  10. Associated injuries in traumatic sternal fractures: a review of the National Trauma Data Bank.

    Science.gov (United States)

    Oyetunji, Tolulope A; Jackson, Hope T; Obirieze, Augustine C; Moore, Danier; Branche, Marc J; Greene, Wendy R; Cornwell, Edward E; Siram, Suryanarayana M

    2013-07-01

    Sternal fractures occur infrequently with blunt force trauma. The demographics and epidemiology of associated injuries have not been well characterized from a national trauma database. The National Trauma Data Bank was queried for patients with closed sternal fractures. The demographics were analyzed by age, gender, mechanism and indicators of anatomic and physiologic injuries. Types of commonly associated injuries were also determined. A total of 23,985 records were analyzed. Males accounted for 68.3 per cent and whites 70.9 per cent. Motor vehicle crash was the leading mechanism. More than 56 per cent had severe injuries based on Injury Severity Score (greater than 15) and 17 per cent with Glasgow Coma Score 8 or less. Crude mortality was 7.9 per cent. The majority (57.8%) and approximately one-third (33.7%) of the patients had rib fractures and lung contusions, respectively, 22.0 per cent with closed pneumothorax, 21.6 per cent had a closed thoracic vertebra fracture, 16.9 per cent with lumbar spine fracture, 3.9 per cent with concussion, and blunt cardiac injury in 3.6 per cent. Sternal fractures are usually associated with severe blunt trauma. Lung contusion remains the leading associated injury followed by vertebral spine fractures. Cardiac injuries are less frequent and vascular injuries less so. Mechanism of injury and presence of sternal fractures should alert providers to these potential associated injuries.

  11. Do we really need new medical information about the Turin Shroud?

    Science.gov (United States)

    Bevilacqua, M; Fanti, G; D'Arienzo, M; De Caro, R

    2014-02-01

    Image processing of the Turin Shroud (TS) shows that the Man represented in it has undergone an under glenoidal dislocation of the humerus on the right side and lowering of the shoulder, and has a flattened hand and enophthalmos; conditions that have not been described before, despite several studies on the subject. These injuries indicate that the Man suffered a violent blunt trauma to the neck, chest and shoulder from behind, causing neuromuscular damage and lesions of the entire brachial plexus. The posture of the left claw-hand is indicative of an injury of the lower brachial plexus, as is the crossing of the hands on the pubis, not above the pubis as it would normally be, and are related to traction of the limbs as a result of the nailing to the patibulum. The disappearance of the thumbprints is because of entrainment of the flexor pollicis longus tendons while the nails were driven through the wrists. The blunt chest trauma, which resulted in the body falling forwards, was the direct cause of a lung contusion and haemothorax, confirmed by the post-mortem leakage of clots and serum from the chest caused by the stabbing with the spear, and was a likely cause of cardiac contusion. All the evidence is in favour of the hypothesis that the TS Man is Jesus of Nazareth.

  12. Acute Pseudohepatitis in a Chronic Substance Abuser Secondary to Occult Seat Belt Injury

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    Eric CS Lam

    1999-01-01

    Full Text Available Causes of a massive elevation in serum aminotransferases (aspartate aminotransferase [AST] and alanine aminotransferase [ALT] in the substance-abusing patient include viral hepatitis and drug hepatotoxicity. A patient chronically addicted to injection heroin and cocaine presented to the emergency room in a confused state and was admitted to a medical ward with an AST of 4120 U/L, ALT 3820 U/L and right upper quadrant discomfort. Investigations for viral and hepatotoxic causes for the liver dysfunction revealed only hepatitis C seropositivity. A computed tomogram of the abdomen, however, revealed a significant contusion to the right lobe of the liver consistent with traumatic injury. A motor vehicle accident, in which the patient was wearing a seat belt, and which had occurred a few days before admission and had been thought to be minor, was the cause of the liver dysfunction. Significant blunt abdominal traumatic injuries are usually managed exclusively by surgical trauma units. This case underlines the need for medical specialists to be aware of hepatic contusion injuries and to have a high index of suspicion when investigating unexplained hepatocellular dysfunction in chronic substance abusers who have been in motor vehicle accidents.

  13. Non-invasive Respiratory Support in Blunt Chest Injury

    Directory of Open Access Journals (Sweden)

    T. V. Lobus

    2006-01-01

    Full Text Available Objective. To optimize the results of treatment in patients with acute respiratory failure (ARF due to lung contusion, by using the methods of non-invasive mask respiratory support. Materials and methods. The study covered 31 patients with severe blunt chest injury, multiple costal fractures, and hypoxemic ARF. The patients underwent assisted ventilation (AV in the CPAP+PSV mode through a facial or nasal mask. Physiological parameters were recorded during non-invasive mask ventilation (NIMV in the stepwise fashion. A control group comprised 25 patients with the similar severity of injury and ARF who were given conventional AV.Results. In 67.7% of the study group patients, NIMV was effective in improving oxygenation and external respiration, without exerting negative hemodynamic effects. Endotracheal intubation and AV could be avoided in these patients. Comparison of the study and control groups revealed a significant reduction in the incidence of secondary pneumonias in the NIMV group and in the duration of treatment. Mask ventilation could decrease mortality from 44% in the control group to 9.7% in the NIMV group.Conclusion. NIMV applied to patients with hypoxemic ARF in the presence of lung contusion improves pulmonary function and, in the bulk of patients, allows endotracheal intubation and AV and consequently their associated complications. When mask ventilation is employed, management of patients becomes shorter and simpler and mortality rates substantially decrease. 

  14. 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 .

  15. Injuries in judo: a systematic literature review including suggestions for prevention.

    Science.gov (United States)

    Pocecco, Elena; Ruedl, Gerhard; Stankovic, Nemanja; Sterkowicz, Stanislaw; Del Vecchio, Fabricio Boscolo; Gutiérrez-García, Carlos; Rousseau, Romain; Wolf, Mirjam; Kopp, Martin; Miarka, Bianca; Menz, Verena; Krüsmann, Philipp; Calmet, Michel; Malliaropoulos, Nikolaos; Burtscher, Martin

    2013-12-01

    There is limited knowledge on epidemiological injury data in judo. To systematically review scientific literature on the frequency and characteristics of injuries in judo. The available literature up to June 2013 was searched for prospective as well as retrospective studies on injuries in judo. Data extraction and presentation focused on the incidence rate, injury risk, types, location and causes of injuries. During the Olympic Games in 2008 and 2012, an average injury risk of about 11-12% has been observed. Sprains, strains and contusions, usually of the knee, shoulder and fingers, were the most frequently reported injuries, whereas being thrown was the most common injury mechanism. Severe injuries were quite rare and usually affected the brain and spine, whereas chronic injuries typically affected the finger joints, lower back and ears. The most common types of injuries in young judo athletes were contusions/abrasions, fractures and sprains/strains. Sex-differences data on judo injuries were mostly inconsistent. Some studies suggested a relationship between nutrition, hydration and/or weight cycling and judo injuries. Also, psychological factors may increase the risk of judo injuries. The present review provides the latest knowledge on the frequency and characteristics of injuries in judo. Comprehensive knowledge about the risk of injury during sport activity and related risk factors represents an essential basis to develop effective strategies for injury prevention. Thus, the introduction of an ongoing injury surveillance system in judo is of utmost importance.

  16. Trauma and pulmonary thromboembolism: an experimental study on their correlation

    Institute of Scientific and Technical Information of China (English)

    GUO Gang; KANG Ying; LI Xu; CAI Ze-hao; CHEN Jiong-hao; WANG Gang; PEI Guo-xian

    2007-01-01

    Objective:To investigate the correlation between trauma and pulmonary thromboembolism.Methods: Comminuted fractures and extensive soft-tissue contusion at both hind limbs were made by a falling weight from a height in 16 rabbits. Lung perfusion scanning was performed to obtain the radioactivity counts before trauma, at 1 h, 48 h and 96 h after trauma. All the data were divided into 4 groups based on the above 4 time points. The rabbits were sacrificed when positive findings on the pulmonary perfusion scanning appeared. Their lungs were harvested to be paraffin-embedded and stained with hematoxylin-erosin method for histological examination of thromboembolism. The randomized block design ANOVA and the method of least significant difference (LSD) were used for statistical analysis of the radioactivity counts.Results: The histological findings showed that pulmonary embolism developed in 6 of the 16 rabbits (37.5% ). Five of the 6 pulmonary embolism rabbits presented neither clinical symptoms nor positive pulmonary embolism manifestations in the lung perfusion scanning. A significant difference was found in lung perfusion radioactivity between the pre-traumatic, post-traumatic 1h groups and post-traumatic 48 h and 96 h groups (P< 0. 05).Conclusions: Fractures of the hind limbs accompanied with extensive soft-tissue contusion may cause pulmonary micro-embolism that is not sensitive to lung perfusion scanning and tends to have no clinical symptoms. Pulmonary embolism development may take more than two days after trauma.

  17. Diagnosis and treatment of 16 cases of pulmonary laceration%肺撕裂伤16例的诊治分析

    Institute of Scientific and Technical Information of China (English)

    毕伟; 刘旭军; 江曙光; 丁长青; 刘德海; 刘文

    2015-01-01

    Objective:To investigate the CT diagnosis and treatment of pulmonary laceration.Methods:16 patients with traumatic lung injury were selected,the clinical data were retrospectively analyzed.Results:CT performance were pulmonary contusion combined with balloon or gas liquid capsule(n=9),pulmonary contusion combined with hematoma(n=6),simple hematoma(n=1). Patients were treated with symptomatic treatment,they were followed up for 1 week to 4 months,the lesions were essentially disappeared.Conclusion:CT was of great value in the diagnosis and treatment of pulmonary laceration.%目的:探讨肺撕裂伤的CT诊断和治疗。方法:收治创伤性肺撕裂伤患者16例,回顾性分析其临床资料。结果:CT表现为肺挫伤合并气囊或气液囊(n=9)、肺挫伤合并血肿(n=6)、单纯血肿(n=1)。临床采取对症处理,随访1周~4个月,病灶基本消失。结论:CT在创伤肺撕裂伤诊断及治疗、随访中具有重要价值。

  18. Evaluation of muscle regeneration in aged animals after treatment with low-level laser therapy Avaliação da regeneração muscular em animais idosos após tratamento com laser de baixa intensidade

    Directory of Open Access Journals (Sweden)

    Adriana Pertille

    2012-12-01

    Full Text Available BACKGROUND: The aging process and its associated morphophysiological changes trigger a reduction in the regenerative ability of the satellite cells, a reduction of vascular tissue and an increase in the production of fibroblasts, developing a cellular environment unfavorable for muscle regeneration. OBJECTIVE: The aim of this study was to evaluate the effect of low-level laser therapy on the muscle regeneration of old experimental rat models after contusion. METHOD: A total of 25 old rats,18 months old, were divided into three groups: control group (CT without treatment; injury group (IN with muscle contusion and without treatment and laser group (LA with contusion and low-level laser therapy, 830 nm, 30 mW e 4 J/cm². The no invasive contusion was induced in the Tibialis Anterior muscle and the samples were collected after 7 and 21 treatment sessions. The muscle was evaluated by Light Microscopy and Immunoblotting. RESULTS: After 21 days of treatment there was a significant reduction in the areas of inflammation/regeneration of the LA 21 group compared to IN 21 group. The cross-sectional area of the fibers in regeneration was not statistically different between the groups. Molecular analysis showed that the content of MyoD was statistically reduced in the IN 21 group compared to the CT group. The Myogenin content was increased in the IN 21 group compared to the CT group. Ultimately, the content of TGF-β1 on the IN 21 group was higher when compared to the CT group. CONCLUSION: Considering the parameters used, the laser therapy demonstrated to be effective for muscle regeneration in old rats, however only through its anti-inflammatory effect.CONTEXTUALIZAÇÃO: O processo de envelhecimento e suas consequentes alterações morfofisiológicas desencadeiam redução da habilidade regenerativa das células satélites, redução da vascularização tecidual e aumento da produção de fibroblastos, desenvolvendo-se um ambiente celular desfavor

  19. Evaluation of muscle regeneration in aged animals after treatment with low-level laser therapy Avaliação da regeneração muscular em animais idosos após tratamento com laser de baixa intensidade

    Directory of Open Access Journals (Sweden)

    Adriana Pertille

    2012-01-01

    Full Text Available BACKGROUND: The aging process and its associated morphophysiological changes trigger a reduction in the regenerative ability of the satellite cells, a reduction of vascular tissue and an increase in the production of fibroblasts, developing a cellular environment unfavorable for muscle regeneration. OBJECTIVE: The aim of this study was to evaluate the effect of low-level laser therapy on the muscle regeneration of old experimental rat models after contusion. METHOD: A total of 25 old rats,18 months old, were divided into three groups: control group (CT without treatment; injury group (IN with muscle contusion and without treatment and laser group (LA with contusion and low-level laser therapy, 830 nm, 30 mW e 4 J/cm². The no invasive contusion was induced in the Tibialis Anterior muscle and the samples were collected after 7 and 21 treatment sessions. The muscle was evaluated by Light Microscopy and Immunoblotting. RESULTS: After 21 days of treatment there was a significant reduction in the areas of inflammation/regeneration of the LA 21 group compared to IN 21 group. The cross-sectional area of the fibers in regeneration was not statistically different between the groups. Molecular analysis showed that the content of MyoD was statistically reduced in the IN 21 group compared to the CT group. The Myogenin content was increased in the IN 21 group compared to the CT group. Ultimately, the content of TGF-β1 on the IN 21 group was higher when compared to the CT group. CONCLUSION: Considering the parameters used, the laser therapy demonstrated to be effective for muscle regeneration in old rats, however only through its anti-inflammatory effect.CONTEXTUALIZAÇÃO: O processo de envelhecimento e suas consequentes alterações morfofisiológicas desencadeiam redução da habilidade regenerativa das células satélites, redução da vascularização tecidual e aumento da produção de fibroblastos, desenvolvendo-se um ambiente celular desfavor

  20. Simulative investigation on head injuries of electric self-balancing scooter riders subject to ground impact.

    Science.gov (United States)

    Xu, Jun; Shang, Shi; Qi, Hongsheng; Yu, Guizhen; Wang, Yunpeng; Chen, Peng

    2016-04-01

    The safety performance of an electric self-balancing scooter (ESS) has recently become a main concern in preventing its further wide application as a major candidate for green transportation. Scooter riders may suffer severe brain injuries in possible vehicle crash accidents not only from contact with a windshield or bonnet but also from secondary contact with the ground. In this paper, virtual vehicle-ESS crash scenarios combined with finite element (FE) car models and multi-body scooter/human models are set up. Post-impact kinematic gestures of scooter riders under various contact conditions, such as different vehicle impact speeds, ESS moving speeds, impact angles or positions, and different human sizes, are classified and analyzed. Furthermore, head-ground impact processes are reconstructed using validated FE head models, and important parameters of contusion and laceration (e.g., coup or contrecoup pressures and Von Mises stress and the maximum shear stress) are extracted and analyzed to assess the severity of regional contusion from head-ground contact. Results show that the brain injury risk increases with vehicle speeds and ESS moving speeds and may provide fundamental knowledge to popularize the use of a helmet and the vehicle-fitted safety systems, and lay a strong foundation for the reconstruction of ESS-involved accidents. There is scope to improve safety for the use of ESS in public roads according to the analysis and conclusions.